APPLICATION FOR STAFF DEVELOPMENT CREDIT
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indicates required fields
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Lastname:
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Firstname:
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Workplace:
Board of Education Office
Bus Garage
Clay County High School
Clay County Middle School
Clay Elementary School
H.E. White Elementary School
Ivydale Elementary School
Lizemore Elementary School
Valley Fork Elementary School
Maintenance Building
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ID Number:
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Date Staff Development Completed:
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Hours Completed:
1
2
3
4
5
6
7
8
10
12
14
16
18
20
22
24
28
32
40
Other (See Description Below)
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Name of Trainer:
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Description of Staff Development Activity:
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Description of Verification You Will Provide:
Clay County Schools
285 Church Street, PO Box 120
Clay, WV 25043
Telephone (304) 587-4266 Fax (304) 587-4181
mail@claycountyschools.org
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