Pitt Community College
Title III Grant
Professional Development Post-Travel Report Form
Pitt Community College Professional Development Post-Travel Report Form Page 1 of 1
Instructions: This form is to be completed and submitted to the Title III Office (VEW 152) within 15 days post-
professional development.
Name: ______________________________________ Position: ______________________________________
Date(s) of Travel: ____________________________ Location of Travel: _____________________________
Name of Conference: _________________________________________________________________________
1. Pos
t-Travel Professional Development option chosen:
Option 1: Discussion/Presentation
Option 2: Interactive Workshop/Activity/Presentation
2. Title of Professional Development: _______________________________________________________
3. Date of Post-Travel Professional Development Event: ________________________________________
4. List of attendees of Post-Travel Professional Development Event (List attendees or attach sign-in sheet)
5. Pl
ease attach an outline of the event (i.e. copy of ppt., agenda, talking points, etc.)
6. Briefly describe how you think your event was received by your colleagues.
I
verify that the information reported on this form is accurate and confirms my completion of the Title III
Grant Travel Polices.
___________________
Signature Date
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signature
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