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Continuing Education Units (CEUs)
Replacement CEU Certificate Request Form
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Online, Self-Paced Courses
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Request for Proposal (RFP): Mississippi Science Matters
Other Services
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Home
About
CEUs
Continuing Education Units (CEUs)
Replacement CEU Certificate Request Form
Workshops
All Workshops
MDE Sponsored
NMEC Sponsored
Online, Self-Paced Courses
RFP
Request for Proposal (RFP): Mississippi Science Matters
Other Services
MDE Regional Service Delivery Model Information
Video Production
Facility Rental
Contact Us
BRAINSPRING PreRegistration Form (Level II)
You must complete this form
PRIOR
to
officially registering for an event on
www.msresaservices.com
. If you do not, your official event registration will be deleted immediately.
Personal Information
Full Name
*
First
Last
Email Address
*
Educator ID / License Number
*
If you do not know this number, you can look it up using the License Look-up Tool at
https://sso.mde.k12.ms.us/Login/Login.aspx
.
Professional Information
School District
*
School
*
School Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Current Position
*
General Education Teacher
Special Education Teacher
Literacy/Academic Coach
Certified Interventionist
Grade(s) Served
*
Check all that apply.
PreK
K
1
2
3
4
5
6
7
8
9
10
11
12
# of Students with IEPs
*
Please enter a number from
1
to
50
.
# of Students without IEPs
*
Please enter a number from
1
to
50
.
District Contacts
Principals's Name
*
First
Last
Principals's Email
*
Curriculum Director’s Name
*
First
Last
Curriculum Director’s Email
*
SPED Director's Name
*
First
Last
SPED Director's Email
*
Previous Training
Which Level I course did you attend?
*
Phonics First® K–5
Phonics First® 6–12
Did you complete online or in person, if in person what city?
*
When did you attend the Level I Phonics First® course? Please enter the DAY ONE date.
*
Month
Day
Year