St. Lucie County School District Applicant’s Name (please print clearly)_______________________________________________

St. Lucie County School District
Request for Reimbursement for Online ESOL Courses Offered by
The Center for Technology and Education or Schultz Center for Teaching and Leadership
Applicant’s Name (please print clearly)_______________________________________________
Current Position___________________________ Work Location__________________________
Home Address
Please check the category to which you belong.
 CATEGORY I Teachers (Primary Language Arts/English Teacher) require 300 hours of ESOL inservice
in classes 1-5 listed below.
 Category II Teachers (Computer Literacy, Math, Science, Social Studies) require 60 hours of ESOL
inservice in any
 Category III Teachers (All others not in categories I and II) require a minimum of 18 hours of ESOL
inservice or any of the first five courses listed below.
 Category IV Guidance Counselors and Administrators require 60 hours of inservice in the course
specifically designed for their area.
Online ESOL Classes offered by
C-Tech Ed or Shultz Center for
Teaching & Learning
Start Date
End Date
Have you
verification of
Have you attached your
canceled check showing
payment for the class or
other documentation that
shows payment?
1. Methods of Teaching English
to Speakers of Other Language
2. ESOL Curriculum and
Materials Development
3. Cross-cultural
Communications and
4. Testing and Evaluation of
5. Applied Linguistics
6. ESOL for Guidance
7. ESOL for Administrators
8. 18 hr. Empowering for
Category III Teachers
I certify that the information provided is correct and the courses that I have taken are required for my current position. I
also understand that reimbursement may be limited by the funds available for this purpose and maximum
reimbursement will be $100 for the cost of the 60 hour online class and $40 for the 18 hour class.
Applicant’s Signature
Please send this form and all required documentation to the Department of Professional Development .
Approved by
Cost Strip
Payment Issued
HRD0049 Rev. 4/11