Recertification Form
Environmental Educator Details:
Full Name
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First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Secondary Email
Used only if your primary email address is no longer valid
Phone Number
*
Format: (000) 000-0000.
Phone Type
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Please Select
Work
Cell
Home/Personal
County, City, or Town in which you primarily work or volunteer:
*
Current environmental education employment or volunteer work, if any:
*
Write N/A if not working or volunteering
If your certification helped you to attain employment or volunteer work, please describe the circumstances.
Describe how Environmental Education Certification has helped to make your EE practice more effective.
Check if you are a member of an environmental education organization:
Virginia Association for Environmental Education (VAEE)
North American Association for Environmental Education (NAAEE)
Other(s)
If you chose "other," please list additional EE organization(s) here:
Professional Development Documentation
Please document your professional development that you completed according to the Menu of Options. Your list must include five different methods of professional development. Thereafter, you may repeat methods. You do not need to fill all 30 rows, but hours must add up to at least 30.
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Rows
Number of Hours
Date of Event/Completion
Completed Activity (method)
Brief Description (e.g., book title, workshop name)
Core Competency(ies) addressed
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2
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4
5
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30
For each item listed above, please attach a brief statement answering the following: 1.) What were your takeaways from this experience? 2.) How did you apply what you learned professionally or how did this activity benefit you professionally? Please number each item to match the item in the table above and then answer the two questions for each numbered item.
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Future Goals
View NAAEE's Guidelines for Excellence: Professional Development of Environmental Educators. Choose some areas for growth and set your goals for the next three years. Note the Core Competency you will be addressing from the PD Guidelines and your planned method(s) for reaching that goal. (Three goals minimum)
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Rows
Goal
Core Competency to be Addressed
Proposed Activity (Select Method*)
Description (e.g., book title, conference name, etc.)
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2
3
4
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Sign and Submit
By signing below, I certify that the above information is true and accurate to the best of my knowledge. I also certify that I have read the Code of Ethics for Professional Environmental Educators in Virginia, and I pledge to comply with standard practices and ethical conduct. I understand that failure to uphold this pledge may result in my conduct being examined by the Certification Advisory Board (CAB), with the possibility of my Virginia Environmental Education Certification being revoked for failure to uphold the Code of Ethics.
Signature
*
Please check over all of your work above before hitting Submit.
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