REQUEST FOR SEMI CREDIT FORM | Mississippi Coaches Association: Online Forms

Name*

First Last

Email*

School or District*

Mailing Address*

Street Address City State ZIP Code

Cell Phone*

TEACHER MS LICENSURE NUMBER OR SOCIAL SECURITY NUMBER MUST BE LISTED BELOW:*

Please select which one you'll be providing.

MS LICENSURE #
SOCIAL SECURITY #

SOCIAL SECURITY #*

MS LICENSURE #*

REQUESTING SEMI CREDIT FOR: (PLEASE CHOOSE ONLY 1)*

5 SEMI: attend 6.25-12.25 hours (must have a minimum of 6.25)
10 SEMI: attend 12.5-18.5 hours (must have a minimum of 12.5)
15 SEMI: attend 18.75 hours or more (must have a minimum of 18.75)
1 OSL: attend 12.5 hours or more (must have a minimum of 12.5 hours- this is credit for entry level administrators)

Acknowledgement*

PLEASE NOTE:

100% attendance is required for SEMI/OSL credit. Participants who miss any portion of the training will not receive SEMI/OSL credit. Additionally, all participants expecting to receive SEMI credit must hold a Standard Career-Level Administrator License, and all participants expecting to receive OSL credit must hold a Standard Entry-Level Administrator License. Session Evaluation forms are required for each session that is attended. Forms will be available at the mandatory Orientation meeting.

I have read and understand these guidelines.

Signature*

Semi Credit Form