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1、附件1榆林市中小学教师校本研修学分认定申请表内容信息姓名李晓雷性别男学校靖边县黄蒿界九年制学校继教证书编号职称二级电话13772377713项目申请事项提供材料申请认定分数实际认定分数初审复审认定研修主题研修计划活动记录研修专题讲座示范教学课题研究学习笔记“大家访”记录班主任校本教材编写指导青年教师听评课记录研修总结研修成果论文发表情况(人名教育、陕西教育及陕西教育科研、榆林教研、县级教育刊物)论文交流获奖情况教学能手评选情况现代教育技术类、自制教具类、指导学生作评类教学成果情况研修学时(培训)考
2、评等级合计学校初审意见审核人(签字)学校(公章)年月日县区复审意见审核人(签字)县教研室(公章)年月日市考核组考核意见组长(签字)年月日officiallyestablishedonJuly1,2013,Yibincity,formerlyknownasthebus,integratedoriginalrongzhoubuscompanyinYibincityandMetrobuscompany,formedonlyinYibincityofaState-ownedpublictransporte
3、nterprises,thecompanyconsistsofoneortwo,thirdDivision.Integrationofpublictransportservicesisnotyetestablished附件2榆林市中小学教师校本研修工作报告单研修人员:工作单位:联系方式:officiallyestablishedonJuly1,2013,Yibincity,formerlyknownasthebus,integratedoriginalrongzhoubuscompanyinYib
4、incityandMetrobuscompany,formedonlyinYibincityofaState-ownedpublictransportenterprises,thecompanyconsistsofoneortwo,thirdDivision.Integrationofpublictransportservicesisnotyetestablished校本研修报告单填写须知《榆林市中小学教师校本研修报告单》为教师校本研修学分认定材料封面,申请人要结合自身研修实际,逐项完善认定相关材
5、料。1.本报告单为一线教师一学年内校本研修活动的完善记录,由教师个人填写后报学校初审,作为教师个人校本研修学分认定的依据。2.研修主题要认真选定,选题要小、实、新、活,尽量与本专业学科对口。报告中所有项目都要围绕研修主题展开,研究要严谨,内容要详实。3.申请材料用Word输入,所填文字均为小四号仿宋体,用A4纸双面打印。4.严禁网络下载或拼凑,违者后果自负。officiallyestablishedonJuly1,2013,Yibincity,formerlyknownasthebus,integ
6、ratedoriginalrongzhoubuscompanyinYibincityandMetrobuscompany,formedonlyinYibincityofaState-ownedpublictransportenterprises,thecompanyconsistsofoneortwo,thirdDivision.Integrationofpublictransportservicesisnotyetestablished研修教师信息姓名李晓雷性别男年龄30学历本科照片工作单位靖边
7、县黄蒿界九年制学校继教编号联系电话13772377713邮箱591213059@qq.com教育格言个人工作简历2007年8月——2011年7月在靖边县黄蒿界中心小学任教;2011年8月至今在靖边县黄蒿界九年制学校任教。officiallyestablishedonJuly1,2013,Yibincity,formerlyknownasthebus,integratedoriginalrongzhoubuscompanyinYibincityandMetrobuscompany,formedonl
8、yinYibincityofaState-ownedpublictransportenterprises,thecompanyconsistsofoneortwo,thirdDivision.Integrationofpublictransportservicesisnotyetestablished校本研修工作计划研修主题研修时间研修内容研修安排备注officiallyestablishedonJuly1,2013,Yibincity,formerlyknownasthebus,