Conference Application Form
Professional Development Funds

Important Notes - Please read carefully:

• IMPORTANT: Due to the increased demand for funds, there is now a cap of $1300.00 per person for the academic year. The cap includes any funds that you may be awarded this fiscal year through professional development funds.
  
  
• Please be as accurate as possible and refer to the guidelines for the listing of non-allowable expenses which cannot be reimbursed through the OFSD.
  
• Be sure to include six (6) copies along with the original application for a total of seven (7) copies when submitting your funding request or your request will be considered incomplete.
  
• Do not attach your receipts with this application.
  
• Please note: The application you fill out online is NOT submitted electronically to the Office of Faculty & Staff Development. You MUST print out the application that you fill out online and it must be signed by your supervisor, then forwarded to the OFSD no later than 4:00 p.m. on the deadline date.

Please complete the application form,
then click on the "Continue" button.

Supervisor's Name:
(Remember: Have your Supervisor sign the application for approval after you have completed and printed the application.)
Name:
Department:
Home Phone or Campus Extension:
Home Address:
E-mail Address:
Employment Status:
	Full-time
	Part-time
Employment Type:
	Faculty
	Staff
Location of Activity:
Date(s) of Activity:
Description of Activity:
Questions (NOTE: Please copy and paste your answers to a Word document so you will have them to retrieve if needed. Once you click the "Continue" button, you will not be able to access what you typed for editing purposes.):
How does the proposed request enhance your professional/job development? (150-250 words)
How does your proposed activity impact student learning/services to students or the college community? (150-250 words)
Anticipated Costs: (NOTE: If a cost field below is not applicable, you must enter "0" (zero) for the amount for your application to be processed when you click the "Continue" button. Dollar sign ($) symbol is not needed and will automatically be added to the form when you click the "Continue" button):
Registration/Conference Fee:
Transportation Costs: (This includes any expense to your transportation not related to airfare or mileage by car - for example: airport shuttle, taxi fee, tolls, etc.):
Hotel Cost: (Include tax in total and calculate the number of nights x total cost):
Mileage - Transportation by car: (UPDATED RATE: Please calculate your mileage at $0.45/mile):
Air Fare:
TOTAL AMOUNT:
TOTAL AMOUNT REQUESTED:
Have you received funding in the prior or current fiscal year?:
	Yes
	No

Before clicking on "Continue", please read this important message:

REMINDER: When you click on the "Continue" button, the application DOES NOT get submitted electronically to the Office of Faculty & Staff Development.

You MUST print out the completed application that appears on the next page, have your supervisor sign it, make the required six copies and forward those copies, along with the original to the OFSD no later than 4:00 p.m. on the deadline date.