Fillable Exempt Employee Long-term Prof Dev Debrief Leave of Absence Form3

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Exempt Employee Long-term Prof Dev Debrief Leave of Absence Form3

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The purpose of a Long-Term Professional Development Leave for an exempt employee is for the employee to
participate in opportunities to grow and learn in a professional capacity.
Part 2 – Debrief must be submitted to the
employee’s supervisor no later than 30 days after the completion of the professional development event or the end
of the academic year in which the activity took place. You will need to submit a request annually for review if
anticipated continuting education extends beyond one year. Prior year summaries or progress reports must
be included in any additional requests.
Exempt Employee Long-Term Professional
Development Debrief - PART 2
DEPARTMENT
TITLE
COCC ID
#
NAME (Last, First, Middle Initial) DATE PREPARED
Complete the following requirements in the spaces provided to REPORT on professional development
activities:
What new knowledge, skills or expertise did you gain from this experience?
What are your plans to share, apply, or incorporate the information gained?
SUPERVISOR SIGNATURE
DATE
EMPLOYEE SIGNATURE
DATE
Copy to:
•Supervisor
•Employee
•Employee File
Long-Term Professional Development Debrief
REV 06.20.2017
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Exempt Employee Long-term Prof Dev Debrief Leave of Absence Form3

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Completed 8 February 2020

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