Microsoft Word - Conference PQAS Application

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PA Keys to Professional Development Approval for
Special Events/Conferences
Guidelines:
Upon approval, PA Key will issue an eventspecific professional development/instructor
approval (i.e. PAKC-XXXXX) that indicates PQAS
approval for the event. This notice will be sent to
the contact person listed below via email. Once
the event has occurred, you will have two weeks
to complete all necessary documentation in the
system.
A Special Event/Conference PQAS request is for
multi-session, multi-instructor events or for national
speakers.
The Organization that is sponsoring the event must
request approval at least 2 weeks prior to the event.
Please submit:
o Goals and purpose of the event
o List of the instructor(s) and PQAS number(s), if
applicable
o Background of the instructor(s)
o Description of session content
o Core Body of Knowledge (CBK) or Core Knowledge
Competencies (CKC) Code for each session
PA Key will provide a PQAS number (PA Key will
create a special PQAS number for such events,
which can be used in granting credit hours). PA
Key will maintain a database of these approvals
to ensure that there are no individuals who
repeatedly seek this “special circumstance” in
lieu of an individual PQAS number.
Please Note: Sessions/Events that require individual
PQAS approval include: CPR, First Aid, Mandated
Reporter, Fire Safety, and Water Safety. College courses
do not qualify for Special Event or Interim PQAS.
Title of Event:
Date(s) of Professional Development Event:
Number of Professional Development Hours (excluding breaks and lunch):
County Where Event is Located:
Name of Sponsoring Organization:
Address:
______
City:
State:
Zip Code:
Name of Contact Person:
Phone:
Email:
Instructions
Complete this form and attach the following documentation:
o Professional Development Event Description/Brochure
o Presenter(s) with short bio or resume, include individual’s PQAS number where applicable
o Title, Description, CBK or CKC Code, and instructor(s) for each session
More information about Pennsylvania’s Core Body of Knowledge (CBK) and Pennsylvania’s Core Knowledge
Competencies (CKC) are available on the PA Keys to Professional Development website at www.pakeys.org
for coding purposes.
Fax completed form to: 717-213-0585 or email to pqas@berksiu.org.
For Internal Use Only:
PQAS Number: ____________________
Date Emailed:______________________
Initials:________
Pennsylvania Early Learning Keys to Quality (Effective 11/1/13)
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