TSBVI Outreach has applied to the ACVREP for CEU credit on the all of our TETN broadcasts. Pending approval we will award 1 ¾ hours credit for individuals watching this TETN on the live broadcast.

Anyone seeking Academy credits (COMS, LVT, VRT) should:

1. Complete the ACVREP Evaluation.
2. Complete the ACVREP Proof of Attendance form and have it signed by an ESC Consultant or Local Administrator that can verify their attendance.
3. Send both of these forms to Kate Moss at TSBVI via fax at 512-206-9320 and maintain a copy for your records.

Upon receipt of these documents and approval from the Academy an ACVREP Certificate will be emailed to the individual. No certificates will be mailed, so make sure you have the correct email address.

DO NOT COMPLETE THIS PAPERWORK IF YOU ARE NOT A COMS, LVT OR VRT. The SBEC CPE evaluation and certificate is all that is needed for TVI, special or general education teachers or paraprofessionals.

ACVREP EVALUATION FORM

Name:

Title:

Email address (please print clearly):

Phone:

ACVREP approved CE program/activity: (Title and Broadcast #)

Program/activity date(s):

Please answer the following questions, indicating your level of satisfaction by circling the appropriate number:

1. The content of the presentation met my expectations:

Extremely Satisfied (1)

Satisfied ( 2)

Neutral (3)

Dissatisfied (4)

Extremely Dissatisfied (5)

2. The presenter(s) provided valuable information that will help me in my profession:

Extremely Satisfied (1)

Satisfied ( 2)

Neutral (3)

Dissatisfied (4)

Extremely Dissatisfied (5)

3. The presenter(s) were knowledgeable and helpful:

Extremely Satisfied (1)

Satisfied ( 2)

Neutral (3)

Dissatisfied (4)

Extremely Dissatisfied (5)

4. Will your job performance or advocacy efforts change in any way as a result of this program?

_____ Yes _____ No _____ Undecided

5. I would recommend this training to my peers/colleagues in the vision rehabilitation and education field:

_____ Yes _____ No _____ Undecided

What information from this TETN broadcast are you most likely to use in your current position?

Comments (please use the back of this sheet if necessary):

Return your completed evaluation sheet to your ESC TVI Consultant. ACVREP evaluations should be fax to Kate Moss at TSBVI Outreach (512-206-9320) with a copy of the ACVREP Proof of Attendance form for this broadcast. Once attendance has been verified and matched to an evaluation form, a ACVREP certificate will be emailed to the participant. You must include a valid email on this evaluation form and ACVREP Proof of Attendance form if you wish to receive a certificate. NO CERTIFICATES WILL BE MAILED. Thanks!

ACVREP Proof of Attendance Form

Participants please complete this section and give it to your ESC contact to sign and ask them to fax this form and your ACVREP evaluation to Kate Moss. Make sure you print legibly and have the correction information so that if any problems arise we may contact you. Thank you.

Participant’s First Name		Participant’s Last Name	Participant’s Title
Participant’s School/Agency
Participant’s Email Address
Participant’s Phone Number	( )
Participant’s Mailing Address

I am verifying that the participant listed below attended the TETN Broadcast _____________________

________________________________________________________________________________________

(Print TETN Title and Number)

on _________________________.

(Date of Broadcast)

Print Name of ESC Consultant or Local Administrator:

Print Title:

ESC Consultant or Local Administrator Signature

______________________________

Date

This proof of attendance form along with the participant’s ACVREP evaluation form should be faxed to Kate Moss at 512-206-9320. Upon receipt of this paperwork, a certificate will be EMAILED to the participant. Please make sure the email address listed above is correct and legible.