Flex Report Form for Professional Enrichment

Name: Date: Phone #: Email:

Flex credit may be earned for attending live performances, exhibits, museums, and demonstrations, when directly related to the faculty’s teaching discipline. A rationale must be provided to support this activity.

Maximum Number of Hours: 16 (2 hours maximum per activity)

Name of live performance, exhibit, museum, or demonstration:

Discipline you teach:

How is this directly related to your teaching discipline:

Date and times:

Hours of Flex you are reporting:

Please describe how this live performance, exhibit, museum, or demonstration helps achieve staff improvement, student improvement, or instructional improvement: