Fillable Professional Dev Activity Proposal Form (Columbia College)

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Professional Dev Activity Proposal Form (Columbia College)

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The Professional Dev Activity Proposal Form (Columbia College) form is 2 pages long and contains:

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  • 50 other fields

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COLUMBIA COLLEGE
Professional Development Proposal
Applicant(s) Name:__________________________________________________________________________________
Date of Submission________________________________________________
□ Classified □ Faculty □ Management
Proposed Activity: _____________________________________________Date(s) of Activity*_____________________
*Please note activity must begin after approval process is complete.
For Committee
Use
1. Write a brief but specific description of the activity. Include the title of the
conference / workshop, location and sessions you plan to attend.
2. Describe how the activity constitutes professional growth.
25 points possible
3. How will this activity benefit Columbia College students?
25 points possible
4. What is your plan for sharing the information you gain at the activity/event you propose to
attend? Please be as specific as possible (groups, locations, dates, etc).
25 points possible
5. Which College Goal(s) does the proposed activity align with? Please describe the connection
between the activity and the College Goal. (College Goals: Student Success, High Quality
Programs and Services, Institutional Effectiveness, Campus Climate, Community Connections)
25 points possible
6. $850 is the maximum amount that will be funded by Staff Development. Please list additional sources of funding for
this proposal that have been secured. Please work with the manager of your area to complete this portion.
Source Administrator Amount Account Number
Division Travel Budget _______________ __________ ____________________________
PEP funds (Leadership) _______________ __________ ____________________________
VTEA funds _______________ __________ ____________________________
AWE funds _______________ __________ ____________________________
SSP funds _______________ __________ ____________________________
Other (specify) _______________ __________ ___________________________
_
7. A preliminary Travel Request is required for the proposal to be considered complete for submission. The Travel
Request must be signed by the area manager. The Travel Request will be retained in the Student Learning Office, and
sent forward for processing if the proposal is funded. The Travel Request should have an attached document that
includes the following info:
Registration costs per individual-back up documentation provided
Mileage costs and plan for carpooling if applicable
Lodging costs and plan for shared lodging if applicable
Airfare if applicable
Estimated miscellaneous costs (bridge toll, hotel parking, ground transportation if flying etc.)
To be filled out administratively and provided for Committee review:
Total estimated cost for activity:______________________________________________________________________
Estimated cost per individual (to be calculated if submitted by a group):_______________________________________
Immediate Supervisor: ____________________________________________________Dept. _____________________
Print Name
___________________________________________________Date _______________________
Signature
Dean: ___________________________________________________Dept. ______________________
Print Name
___________________________________________________Date _______________________
Signature
Vice President of Student Learning:__________________________________________Date _______________________
Signature
Office Use ONLY
Request Received ____________________________Staff Development Committee Review Meeting Date _____________________
The proposal decision by Committee:
□ Fully Approved/Funded □ Partially Approved/Funded □ Not Approved/Funded
Record of applicant’s previous use of Staff Development funds over the past 2 years (previous date(s) and amount(s):___________________
Staff Development funds approved for the amount of $________________ (per person, if applicable)
Total Funds Approved $ _________________
Tracking Paper Work:
Individual & Dean notified of Committee decision Date ____________ By ___________
Follow-up to proposal returned Date ____________ By ___________
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Professional Dev Activity Proposal Form (Columbia College)

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Completed 18 July 2020

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