Fill - Free fillable State Continuing Education Clock Hours (SCECH) Program Application (Michigan) PDF form

State Continuing Education Clock Hours (SCECH) Program Application

SCECH Program Applications are only be able to be submitted to the State by a SCECH Sponsor's Coordinator

using the Michigan Online Educator Certification System (MOECS). This form is designed as a template to

send information to the coordinator if needed. Please COMPLETE THE ENTIRE FORM, attach the required

documentation to this application, then submit it to your local SCECH Sponsor’s Coordinator.

Program Application Number: Approval Number:

Date Submitted to Coordinator:

Coordinator Use Only

New Program? Update to an existing program? Approval number:

Application Details

*Program Title:

Program title should be unique and distinctive. Maximum of 80 characters/spaces.

*Program Format: *Display in Catalog?

At Sponsor location:

*Location of Meeting:

*Address:

*City/State/Zip:

*Program Category**:

**Category MUST be School Counseling for programs offering hours in College, Career, or Military areas.

*Course

Narrative:

d asterisk ( * ) designates a Required field.

Yes

Choose One

Choose

Yes

Select One

*Prerequisites/Restrictions:

(Class or program that must be completed before this program)/(Program restricted to specific

school/teaching subject/grade level) Please label responses when other than none.

*Attendance Method /

Internal Notes:

*Technical Specifications for

Virtual/Online Programs

*Participation Fee:

(Total amount required from participants to attend and earn SCECHs. If amount

varies, state variations in Course Narrative)

Maximum Contact Hours for Complete Program:

• MOECS allows values starting at two (2) decimal places in quarter hour increments.(ex.1.25)

• All programs will offer a range of hours with the minimum at zero “0”

Sponsors have the authority to award or deny partial hours for a program. Sponsors will be required to make the

decision on a program-by-program basis as to how the hours are awarded. How do you wish the attendance

requirements for this program to be:

 Participants must attend all of the program to receive any hours; or

 Participants can earn the hours they attend without participating in the complete program.

If the program is for School Counselor Category per (MCL 380.1233), separate the hours by content area:

Maximum General School Counselor Hours:

Maximum College Preparation School Counselor Hours:

Maximum Career Exploration School Counselor Hours:

Maximum Military Options School Counselor Hours:

• School Counseling programs - Hours must be offered in at least one (1) type of school counselor area.

Leave the areas blank where no hours are being offered.

*Program Descriptors: *1)

IACET Program?

*Required Document File Name:

Program Type Documentation Attachment Required

Internet/Web Based Programs Topic Description/Schedule

College Conversion College Verification Letter

IACET Programs Original Certificate

Military Training Training order

Individual Professional Activities Responses to Questions

National Board for Professional Teaching Standards NB SCECH Rules

Accreditation Review/Site Visit Accreditation Team Schedule/Visit log

State Board Appointed Advisory Committee Meeting agendas

Choose One

Program Details

How many times will the complete program be offered?

(This number will indicate how many Offering

lines you use below)

Program Offered

*Start Date *End Date *County

Offering 1

Offering 2

Offering 3

Offering 4

(attach more if needed)

Contact Details

College Conversion: College Name:

College Contact Phone: College Credits Offered:

Program Contact

*Program Contact Name:

*Program Contact Phone:

*Program Contact Email:

Program Website:

Contact Signature(s)

Originating District:

Sponsor Information

Program Sponsor:

Coordinator:

Assistant Coordinator:

Information about your program:

What are the learning outcomes and objectives for your program? Please provide information on what

participants will be able to do as a result of attending, and the overall purpose of the program.

Evaluation Questions

You have the option to include extra questions to the online Participant Evaluation. Additional

questions? We encourage program specific questions. These (up to five) can be in any format and

added to the standard online evaluation.

Standard questions for every program:

1. Describe two (2) ways you could apply this new knowledge or skill in your role as an educator.

2. Please provide feedback to the facilitator or sponsor regarding the program’s structure, content,

delivery, or any other comments you would like to share with the facilitator.

Extra questions to add:

Question Type

Question

Answers if multiple choice:

Question Type

Question

Answers if multiple choice:

Question Type

Question

Answers if multiple choice:

Question Type

Question

Answers if multiple choice:

Question Type

Question

Answers if multiple choice:

Choose one

Presenter Information (Copy as needed)

Presenter Name:

Presenter Title:

Company/Institution: