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2. Purpose of this Form
   All CCL Staff must submit this completed for each continuing education session and/or workshop she/he has attended. This includes County Orientation, CCL New Employee Orientation, Respectful Workplace, conferences, education sessions or workshops conducted by CCL, the County or an off-site provider.
   
   The information from this form is entered into the CCL Continuing Education database. From the dataset, a monthly report is generated and submitted to CC Human Resources Department and a quarterly report which is submitted to CCL Department heads. These reports are used for several purposes:
   
   - To meet the continuing education documentation requirement for the Library Code this is required so that the Library can receive State Aid.
   - To provide documentation for the County of Chester’s Performance Appraisal process.
4. Please list the name of the course exactly as it appears in the catalog, brochure, etc.
6. Employee's Name*
7. Library / Department*
9. Dates Attended*
   Dates Attended Start Date

   —

   Dates Attended End Date
10. Phone Number*
12. Email Address*
14. Name of Course / Workshop / Education Session*
16. Number of Hours for Course / Workshop / Education Session*
18. If you work more than 20 hours per week (more than 1,000 hours per year), please provide a brief report (2 - 3 sentences) about what you learned in this continuing education opportunity.
20. Who conducted the Course / Workshop / Education Session?*
    -- Select One --Chester County LibraryCounty of ChesterProfessional OrganizationOther
22. Please name Professional Organization / Details
24. If other, please specify.
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field