REGISTRATION FORM for Graduate Level Credit Heinemann Digital Campus Courses



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REGISTRATION FORM for Graduate Level Credit Heinemann Digital Campus Courses Fax form to 949-754-1337(secure), or mail to: Brandman University Extended Education, Heinemann Practicum 16355 Laguna Canyon Rd, Irvine, CA 92618 Questions? k12@brandman.edu Phone: 800 632-0094 Name: Address: City: State: ZIP: Phone Nos. Home/Work: Email: Social Security #: Birth Date (required): List Course Completion Date: Payment Information Check: Make payable to Brandman University Total Payment $ Signature: Card Type (check): Visa Master Card Discover Credit Card No.: / / / Expiration Date: / Zip Code 3-Digit Security Code (if different from home address): (located on back of credit card): Course # Course Title # of Credits Fee 1,2, or 3 credits 1 EDLU 9063 Adolescent Rdg, RX: When Teen Rdrs Can t 1, 2, or 3 $65/$130/$195 2 EDLU 9061 Harnessing Common Core Standards Rdg and Wrtg 1, 2, or 3 $65/$130/$195 3 EDLU 9062 Introduction to Writing Workshop, G 3-5 1, 2, or 3 $65/$130/$195 4 EDLU 9088 Kids with Grit 1, 2, or 3 $65/$130/$195 5 EDDU 9182 Making Math Far More Accessible 1, 2, or 3 $65/$130/$195 6 EDDU 9318 Putting the Practices into Action: Implementing the Standards for Mathematical Practice 1, 2 or 3 $65/$130/$195 06.09.15

7 EDDU 9317 Smarter Charts: Bringing Charting to Life 1, 2,or 3 $65/$130/$195 8 EDLU 9093 Teaching Nonfiction Writing, K-2 1, 2, or 3 $65/$130/$195 9 EDLU 9094 Teaching Nonfiction Writing, G 3-5 1, 2, or 3 $65/$130/$195 10 EDLU 9090 Teaching Reading in Small Groups 1, 2, or 3 $65/$130/$195 06.09.15

EARN 1, 2, or 3 Graduate Level Credits Heinemann Digital Campus Course and Practicum Course Description This course offers educators the opportunity to earn university credits by completing a Heinemann Digital Campus course. Credit Information Brandman University will award 1, 2, or 3 semester hours of graduate level professional development credit based upon successful completion of course requirements. These credits are not part of a degree program but instead are primarily used for professional advancement (such as salary increment steps and recertification). Students should seek approval of appropriate district or college officials before enrolling in these courses to satisfy any degree, state credential, or local school district requirements. State licensing departments vary regarding their criteria for credit acceptance, and some states may not accept credit from universities that are located outside the state. Course Requirements 1. Complete the online course within the 120 day window. 2. Develop practical activities based on the online course. The activities must be designed so that they can be implemented in your classroom or program. They may be geared to K-12 students, staff or others, based on your position. 3. Conduct activities in your classroom/work setting. If not currently in a classroom setting, refer to FAQs on our website: www.brandman.edu/program/provider-partners. 4. Complete a written report that describes each activity. Each activity must be at least one full page (not including title page or documentation), typed and single-spaced. Use a 12 point font and one inch margins. Staple the paper together. Do not send the paper in a report cover. Complete your report individually; no group reports are permitted. 3 activities required for 1 credit 6 activities required for 2 credits 9 activities required for 3 credits 5. The report must include a Title Page with your name, address (for sending your grade), Brandman ID # and course number (refer to confirmation letter), title of course, course date, and a brief (one paragraph) description of the course. The title page must also include the grade level, number of students, and any special information about the student population (e.g. at risk, ESL, etc.). 6. You will be graded on the accuracy of the title page, each of the components in # 8 below as well as the Quality of the Overall Paper, which includes the format, grammar, spelling, punctuation, required length, and other overall qualities. 7. Write about each activity separately. Use the subheadings below to report on each activity. Label subheadings clearly. A. Activity Description: Describe each activity in detail, using narrative form (no bullets, no numbers, no incomplete sentences). List all materials that you and the participants used (e.g. handouts, books, props, etc.) Describe each activity thoroughly as if the reader were not familiar with the topic. B. Learning Objectives: Write specific learning objectives for each activity. Include what you wish to achieve and how you will accomplish it. C. Appropriateness of Activities for Targeted Students: Explain how the activities meet appropriate developmental needs of the participants/students. D. Correlation of Activities to the Online Course: Discuss how the activities relate to the course content. E. Student Evaluation and Assessment: Evaluate the students learning experience and describe the assessment methods. Relate the assessment to objectives stated in B above. F. Self Evaluation: Write a self-evaluation of your own strengths and weaknesses as you developed and implemented these activities. Discuss what you would do differently next time and suggest areas for improvement, if any. 8. Include Documentation for each activity (e.g. student samples, photos, handouts, or lessons plans). Samples should be limited to 1 or 2 pieces for each activity and fit in a 9x12 envelope. The samples and the paper will not be returned. Submitting Report Upon registration you will receive a confirmation letter/receipt, Brandman ID # and the name and address of your grader. Send your coursework to that address. Do not send coursework to Brandman University or Heinemann. Grading takes approximately 4 weeks. A copy of your online course completion certificate must be included with your report to be accepted for grading, The final report is due (postmarked) six months from the end date of the online course with no extensions. Your report will not be returned to you. You will receive a grade by mail. Confirmation Letters Upon registration, students will receive a confirmation letter, which also serves as your receipt for the course. You may safely assume that your registration will be successful, and you may view the rubric below:

How to Register for Graduate Credit 1. By mail: Send the Brandman University registration form along with your payment to: Brandman University, Extended Education, Heinemann Practicum, 16355 Laguna Canyon Rd., Irvine, CA 92618. 2. By fax (secure fax server): Include your credit card number and fax the registration form to: 949-754-1337. 3. Submit your registration form within 30 days of having completed the Heinemann online course. 4. Your confirmation letter from Brandman University will serve as your receipt but a statement of account may also be printed after activating your student account. Information will be provided after registration. 5. Upon registration, you will receive via email, a user name and password to activate your Brandman Account. This allows you to view grades, print a statement of account, an unofficial transcript, and to order an official transcript. 6. Frequently Asked Questions (FAQs) may be found on our website: www.brandman.edu/program/provider-partners. 7. Further questions email: k12@brandman.edu or phone 800-632-0094. 8. Information on ordering a transcript may be found at: www.brandman.edu/extended-education/student-resources

Grade Form/Rubric for Practicum Courses Name: Seminar Title: Address: Grader: Date: No. of Graduate Level Professional Dvpt. Credits: Title Page (0-2 points) COMPONENTS Pts. COMPONENTS Pts. 2 - Includes all information described in report requirements 1 - Most information included; seminar summary missing 0 - Information missing or inaccurate Activity Description (0-4 points) 4 - Outstanding, detailed descriptions of all activities 3 - Good detailed descriptions of all activities 2 - Good descriptions of most activities 1 - Most activities only meet minimum standards 0 - All descriptions are incomplete or poor Learning Objectives (0-3 points) 3 - Goals and objectives based on student learning, written clearly and specifically for each activity or project 2 - Goals and objectives stated in general or vague terms 1 - Goals and objectives not included with every activity or project 0 - Goals and objectives not included at all Appropriateness of Activities for Targeted Students (0-1 point) 1 - Activities appropriate for grade and ability levels 0 - Activities inappropriate or targeted students not defined Correlation of Activities to the Seminar (0-1 point) 1 - All activities correlated to seminar topic 0 - Correlation of activities to seminar was unclear Student Evaluation and Assessment (0-2 points) 2 - Provides thorough evaluation of the students learning experience and describes the assessment methods in detail. Assessment relates clearly to learning objectives. Samples included as appropriate 1 - Evaluation and assessment methods are not detailed and/or do not correlate with objectives 0 - Evaluation and assessment methods are not present in all activities or are too general and vague Subtotal Comments: Self-Evaluation (0-2 Points) 2 - Includes detailed, thorough self-evaluation of strengths and weaknesses and makes suggestions for improvement 1 - Self evaluation is present but requires more detail 0 - Self evaluation is absent Quality of Overall Paper (0-2 points) 2 - Professional presentation, graduate quality, with subheadings, correct format, grammar, punctuation and spelling 1 - Good presentation; but contained format, grammar, spelling and punctuation errors, and/or less than required length 0 - Paper was not graduate quality: it contained multiple format, grammar, spelling and punctuation errors, and/or was significantly less than the required length Documentation (0-3 points) 3 - Clear examples of documentation for every activity/project are attached 2 - Examples of documentation for 2 out of 3 activities attached 1 - Examples of documentation for 1 activity/project is attached 0 - No examples of documentation are attached Subtotal TOTAL POINTS GRADE Grade Scale: A = 20-18, B = 17-16, C = 15-14 No Pass = 13 - Below Questions? 800-632-0094 k12@brandman.edu Office Use Only: Brandman ID Number: