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Continuing Education Activity Plan Instructor's Form
This form is to be completed by either the instructor or RID Sponsor and kept on file with the Sponsor form. The RID Sponsor will submit the completed Activity Plan online by logging into their account at www.rid.org at least 30 days in advance of the activity.

 * =  Required Field
 
 * RID Sponsor Name: MCDC-DODHH-Joy Thomassen & 
 * Presenter/Instructor Name (Please mail, fax or email your bio/resume for our files):
    
 * Date of Activity: fdsf
 * Start Time for Activity:
     :   am pm
 * Ending Time for Activity:
     : am pm
 * Title of Activity:
Level of Participant's Prior Knowledge of Topic:
Little/None Some Extensive Teaching
 
 * Target Audience:
 
 * Workshop/Course Description:
 
 * Educational Objective (List specific observable actions by participants that will demonstrate comprehension and
     integration of information presented.):
 
 * Media/Materials (List the print, audio and visual materials you will use. Who is responsible for providing them?)
 
 * Evaluation & Assessment (Describe how you will evaluate student learning & presentation effectiveness.)
 
Once paperwork is submitted, an electronic copy of your request will be e-mailed back to you for your records.
Email:

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