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Webinar Educator Survey-Self-Paced ACT 48 credits

This form is to be completed AFTER viewing a WPSU Professional Development Webinar at wpsu.org/educators in order to receive Act 48 credit.

Pursuant to the Family Educational Rights and Privacy Act (FERPA) the information below is needed in order for Penn State to report your Act 48 hours to PDE. Please answer each question below to receive Act 48 credits.

If you have any questions about this survey, please email WPSU Education at education@wpsu.org.

Name * First Last
PPID *
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number * ### - ### - ####
Email *
Name of webinar you viewed *
Date of webinar viewing * MM / DD / YYYY
Please choose the options that best describes you. Choose all that apply. *
Educator School Administrator Community Partner Parent Student Other

Please select how much you disagree or agree with the following statements. *
	Strongly Disagree	Disagree	Agree	Strongly Agree
The webinar was well organized.	1	2	3	4
The webinar met my expectations.	1	2	3	4
The webinar stimulated my interest in the subject.	1	2	3	4

What information from this webinar was of value to you and why? *
What information from this webinar will you share with a colleague and why? *
Please share how you will implement the content into your practice. *
What outcomes or changes do you hope to see because of incorporating the content into your practice? *
What other topics would you like to see WPSU offer for Professional Development?
Additional Comments
Would you like to receive the WPSU Educator Newsletter? *
Yes No
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