Positive Discipline Associate (PDAIT) Checklist
Contact Information
Name:
Work Phone:
Home Phone:
Cell Phone:
Address:
State:
Zip Code;
Country:
Email:
Mentor's Name:
Attended Teaching Parenting the Positive Discipline Way
(This is a mandatory workshop.)
Facilitator:
Date:
Location:
Attended Positive Discipline in the Classroom Workshop
[This must be done some time before attending the Advance PDAIT Training (APT) even if you don't intend to work with classroom teachers.]
Facilitator:
Date:
Location:
Completed the Following Steps Towards Membership:
- Paid annual membership dues ( For 2008, $150 prior to March 1 or $200 after March 1) - Date:
IMPLEMENTATION REQUIREMENTS
FOR CERTIFICATION
CERTIFICATION IN TEACHING PARENTING (TP) ONLY
Requirement -- Facilitate two seven-week parenting classes and submit the Face Sheet and Evaluation Forms. (Found in Facilitator's Manual - Section 1.)
Parent Series 1
Start Date:
End Date:
Location:
Number Attending:
Sent in Evaluation Forms - Date:
Parent Series 2
Start Date:
End Date:
Location:
Number Attending:
Sent in Evaluation Forms - Date:
CERTIFICATION IN POSITIVE DISCIPLINE
IN THE CLASSROOM (PDC) ONLY
Requirement -- Complete and send in evaluations with the face sheet for one of the following options:
Implemented class meetings in my classroom:
Start Date
End Date:
Grade Level:
School:
Location:
OR
Helped two other teachers implement class meetings in other classrooms:
Class 1
Start Date:
End Date:
Teacher's Name:
Grade Level:
School:
Location:
Class 2
Start Date:
End Date:
Teacher's Name:
Grade Level:
School:
Location:
TO BE CERTIFIED IN PDC AND TP I HAVE:
Met requirements for PDC Certification - Confirmed by PDA Office - Date:
Met requirements for TP Certification - Confirmed by PDA Office - Date:
ALTERNATIVE ROUTE FOR MEETING THE IMPLEMENTATION REQUIREMENTS
If you have had extensive experience in implementing Positive Discipline in other settings or formats, etc., you are welcome to submit a proposal requesting consideration and approval by the Board of Directors for utilizing these to meet the implementation requirements. You will want to detail your experiences and provide appropriate evaluations/references. Contact Kathy Rinehart, the Executive Director of the PDA, for more information.
TO COMPLETE CERTIFICATION REQUIREMENTS
I HAVE ATTENDED
THE ADVANCED PDAIT TRAINING (APT):
Date:
Location:
Facilitators:
OTHER:
APPROVED FOR CERTIFICATION
BY THE PDA BOARD OF DIRECTORS - DATE:
For a printable, one-page version
of the PDAIT Checklist,
please contact the Positive Discipline Association
at posdis@satx.rr.com.