Mandatory FLEX Day Activity Proposal Form
Name of Presenter/Facilitator/Contact Person:
Title of Activity:
How many hours will you need for your activity?
Do you prefer a morning or afternoon time slot?
Room Preference:
Date Submitted:
Employee Signature:
Please provide a brief description of your activity. Be sure to specifically address how this
activity supports staff, student, or instructional improvement. You may also wish to mention
specifically how your activity supports the College’s Mission Statement and/or Institutional
and Strategic Goals. If you feel that your proposal should be considered for "Keynote"
status please indicate below as well. Attach additional pages or supporting documentation
if necessary. Please include a written summary to be included in the program.
Step 1: Complete this form if you plan on presenting during a Mandatory FLEX Day.
Step 2: Submit the completed form Professional Development Committee Coordinator by the deadline.
Forms not submitted by then will not be honored.
Step 3: You will be notified by the PDC Coordinator whether or not your proposed activity has been
approved or denied. Please note that time and room preferences cannot be guaranteed, but the
committee will make a sincere effort to schedule activities in accordance with your stated preferences.
Either is Fine
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