Appendix C Revised: 7/1/17

IPDP Approved

Date	

LPDC Preapproval of Equivalent Other Activity (EOA)

All EOA work must clearly relate to the Individual Professional Development Plan (IPDP) on file.

Name	

Present Assignment	               Building	

Name of Equivalent Other Activity (from EOA options):	

Date(s) of Activity	               Contact Hours	

Activity Objectives:	

Complete the following. Please type or print legibly.

1. This activity supports my IPDP by	

2. This activity relates to building or district goals by	

3. This activity enhances my professional growth by	

4. This activity will impact student learning by	

Educator’s Signature	Date

To be completed by LPDC only

Check one:	APPROVED for	EOA contact hours for _____ CEUs	NOT APPROVED

LPDC Verifying Signature	Date Comments:

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