COURSE INFORMATION Primary Contact Email * Required
This contact will receive confirmation of form submission.
Submission Type * Required
New courses will require a syllabus or course outline to be attached for approval purposes.
Course Title * Required When was this course last offered? * Required
list the semester and year, ex Spring 2016
Has the course content changed since the last offering? * Required INSTRUCTOR INFORMATION Has the instructor previously taught K-12 PD for Boise State University? * Required
Current status as a Boise State faculty member does not automatically apply to K-12 Professional Development courses. If the instructor for this course has not previously taught a K-12 Professional Development course, please select 'No'.
Instructor Name * Required
Boise State Employee/Instructor ID
Leave blank if you are unsure.
Instructor's Phone * Required Instructor's Email * Required Instructor's Email * Required
Home Phone * Required Home Address
* Required Name of School/Organization * Required Date of Birth * Required
Citizenship Status * Required US Citizen Permanent Resident In the United States on a Visa Country of Citizenship * Required EDUCATION Highest Degree Earned * Required Area of Study * Required Awarding Institution * Required Year Awarded * Required Areas of Endorsement/Certification * Required PROFESSIONAL EXPERIENCE
Please list your work experience in chronological order,
starting with your present position. 1. Title or Position * Required School/Organization * Required Dates of Employment * Required 2. Title or Position School/Organization Dates of Employment 3. Title or Position School/Organization Dates of Employment SECONDARY INSTRUCTOR INFORMATION Do you have a secondary instructor for this course? * Required Has the secondary instructor previously taught K-12 PD for Boise State University? * Required If the secondary instructor has not previously taught a K-12 Professional Development course at Boise State University, they must complete an Instructor Application. Secondary Instructor Name * Required
Boise State Employee/Instructor ID for Secondary Instructor
Leave blank if you are unsure.
Secondary Instructor's Date of Birth
Secondary Instructor's Phone * Required Secondary Instructor's Email * Required
COURSE DATES Start Date of Course * Required End Date of Course * Required Date when all coursework must be completed. * Required
Last date assignments will be accepted to receive a passing grade.
Date when registration should be closed. * Required
The last date students can register for PD credits.
Course Type * Required Total number of meetings * Required Total number of contact hours * Required
Your course must have a minimum of 15 contact hours per credit to be considered.
Days and times class will meet * Required
Ex: MTWThF, 9 am - 1:30 pm
Location * Required Number of PD credits * Required
Boise State PD credits require 15 contact hours per credit, are $60 each, and are Pass/Fail.
Name of school district, organization, or agency providing or sponsoring the course. * Required COURSE DESCRIPTION Course Description * Required Educational goals/objectives of this course * Required ADDITIONAL INFORMATION Resources * Required
Please list any learning resources utilized for this course (training materials, readings/texts, videos, web tools, etc.)
Credit Requirements * Required
Please list any and all requirements (assignments and assessments, out-of-class work, readings, etc.)
PO OR UNIVERSITY DEPARTMENT PAYMENT Will credit fees be paid by someone other than the student? * Required
This may be through a PO, a district invoice or a university department accounting code.
Will this Payment cover all or only some of the outstanding credit fees for each student, with the remaining balance to be paid by registrants? * Required How much of each registrant's fees will be paid? * Required Is this part of a Grant? * Required If a University Department, please include the account number Payment Contact Name * Required Payment Contact Phone * Required Payment Contact Email * Required Please note: Invoices will be dispatched via email. It is very important that the email address provided be current and accurately entered.
COURSE PROMOTION Is this a district-specific offering? * Required Is registration for this course open to the public? * Required Would you like Boise State's K12 PD Program to promote your course? * Required
Promotion includes emails to K12 educators and a course listing on our website.
Do students need to enroll in the course using another link or website? * Required Please provide the link to the page(s) that students will need in order to enroll in your course. - enter a valid website URL for example https://www.google.com * Required
What is the deadline for students to enroll in the course? * Required Boise State Credits are $60 per credit. Are there any other fees the student will pay? (Ex: course fee, enrollment fee, materials, etc.) * Required How much is the additional fee? * Required What does the additional fee cover (ex: enrollment fee, material fee, assessment fee, etc.)? * Required SUPPLEMENTAL DOCUMENTS
It is strongly advised that you attach supplemental documentation to this form before submitting (i.e. course syllabus, schedule, instructional materials, etc.). File formats you may upload include PDFs and Word documents.
You may upload a total of three documents with this form. If you need to provide more, please email them to
Attach first supplemental document. Allowed file extensions include pdf, docx, doc. Max file size is 10MB
Maximum file size - 10 mega bytes. File 2
Attach second supplemental document. Allowed file extensions include pdf, docx, doc. Max file size is 10MB
Maximum file size - 10 mega bytes. File 3
Attach third supplemental document. Allowed file extensions include pdf, docx, doc. Max file size is 10MB
Maximum file size - 10 mega bytes. Before Submitting If there is an issue with the field when you click submit, you will be redirected to the top of the page. If this happens, your application has not been submitted successfully.
Your information will still be in the fields and any issues will be highlighted in red. A common error is the date format, which needs to be completed with mm/dd/yyyy.
If your application is successfully submitted, you will be directed to a confirmation screen with a blue checkmark. You will also receive a copy of the form in your email.