AIM Institute - Act 48 / Act 45 Credits

AIM Institute - Act 48 / Act 45 Credits

Please only complete this form once per course.

Participant Last Name*

Legal last name

Participant First Name*

Legal first name

Middle Initial

Street Address*

City*

State*

Please use the two letter state code

Zip Code*

Phone Number*

Phone

Participant Email*

Please use the same email you used to take the course.

Today's Date*

Please enter as MM/DD/YYYY

Is this for Act 45 or Act 48?*

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Did you complete your course?*

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Did you receive a Certificate of Completion?*

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Course Name*

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If you completed Steps to Literacy Modules, please select the course(s).*

Select

Name of Cohort or Organization*

Did you complete your Literacy Plan?*

Select

Course Start Date*

Please enter as MM/DD/YYYY

Course Completion Date*

Please enter as MM/DD/YYYY

Course/Activity Type

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PPID Number*

To locate your PPID#

https://www.perms.pa.gov/Screens/wfPublicAccess.aspx

Access the TIMS (Teacher Information Management System)

https://www.education.pa.gov/Educators/Certification/Application/Pages/default.aspx

Your PPID is located on your TIMS personal profile page

Participant Agreement*

By checking this box, you are signing this agreement electronically and are indicating that all information is true to the best of your knowledge. Checking this box is the legal equivalent of your manual signature.

File Upload*

If Act 48, please attach your certificate of completion here. If Act 45, please attach your completed AIM Literacy Leadership Plan here.

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