BASICS: TPS Foundations Registration

Complete this form to register for TPS BASICS: Beginning Asynchronous Individualized Course of Study.

Once submitted, a link to the PRE-EVENT SURVEY will open. BOTH registration AND survey results must be submitted before login information will be emailed.

If you have any questions or need assistance please email Matt Mandarino at tps@waynesburg.edu.

Have you previously attended a TPS professional development event?

Have you previously attended a TPS professional development event? Yes No If yes, please enter event title and approximate date
Name Name First Last
Role (select your primary role)

Role (select your primary role) Administrator Classroom Teacher Curriculum Coordinator Librarian Media Specialist/Technology Coordinator Professional Development Provider School of Education Faculty Teacher Candidate/Student Teacher Other (please specify) Other (please specify)
Grade Level Taught (select one)

Grade Level Taught (select one) PreK-2/Early Childhood/Lower Elementary Level 3-5/Elementary Level 6-8/Middle Level 9-12/Secondary Level 13+/College or University Level I do not work directly with students Other (please specify) Other (please specify)
Subject Taught (select one)

Subject Taught (select one) All/Self-Contained Classroom (e.g. Elementary) Art/Music Bilingual/ESL English/Language Arts Library Mathematics Sciences Social Studies/Social Sciences Special Education/Gifted Technology None/Not applicable Other (please specify) Other (please specify)
Email

Please provide your primary email address.
Summer/Secondary Email

Please provide your summer/secondary email address.
District/Institution/University Affiliation

Please indicate the school district/institution you are affiliated with, where you work.
District/Institution/University Affiliation Address
State
Zip Code
Minimum of 5 characters required. Currently Entered: 0 characters.
Congressional District (Institution/University Affiliation) To find the Congressional District: click here
Phone Phone - ### - ### ####

Please provide your day time phone number.
Cell Phone (optional) Cell Phone (optional) - ### - ### ####
PA Department of Education ID Number (PA Residents Only) If you don't know your number it can be obtained here.

Please provide your Pennsylvania Department of Education Identification Number.
How did you learn about this professional development opportunity?

How did you learn about this professional development opportunity? Direct Communications from TPS Eastern Region Supervisor Peer Conferences Social Media Web Search Other (please specify) Other (please specify)
I understand that the pre-event survey will open in a separate window and that I must submit a response to the survey before login information will be emailed to me.

I understand that the pre-event survey will open in a separate window and that I must submit a response to the survey before login information will be emailed to me. Yes, I understand. No.