Directions: This report must be submitted to the State Board of Education by June 30 annually in accordance with Section 25.860 Reporting by and Audits of Providers 23 Illinois
Administrative Code. Please e-mail the report to: PDAudits@isbe.net.
APPROVED PROVIDER NAME REGION, COUNTY, DISTRICT, TYPE CODE
ADDRESS (Street, City, State, Zip Code)
1. List all subcontractors, third party providers on whose behalf you issued professional development hours, from July 1 to June 30 of the current scal year, AND
2. For each subcontractor include the name, date, and a summary of each activity provided and a statement indicating how each professional development activity was intended
to impact:
A. Educator and student growth in regards to content knowledge or skills, or both; OR
B. Educator and Student social and emotional growth; OR
C. Alignment to district or school improvement plans.
Subcontractor Name Activity Name
Activity Date
(mm/dd/yyyy)
Summary of Activity
Intended Impact on Growth or Alignment
to Improvement Plans
(A or B or C above)
ISBE 73-59 (9/17) Do not type beyond space provided
100 North First Street, E-240
Springfield, Illinois 62777-0001
ANNUAL APPROVED PROVIDER REPORT
EDUCATOR EFFECTIVENESS DIVISION
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