(SSSC) Workshop Approval for Certification 

Name: _______________________________ Building______________________

SS# _______________________________ Date:________________________

Signature: _____________________________ Date Workshop Begins:__________

Name of Workshop: ______________________________________________________

Workshop Description:

Number of Hours:_______________________

If applicable, number of CEU's offered: ______________________________________

How will this Workshop be useful to you as a teacher?

Approved: _______________________________________________

Not Approved: ___________________________________________ 6/95

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