Fillable Shoreline community college 1964 Society Associate Faculty Professional Development Application

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Shoreline community college 1964 Society Associate Faculty Professional Development Application

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Fund 252 – Shoreline CC 1964 Society Page | 1 Updated 10/6/17
16101 Greenwood Ave N
Shoreline, WA 98133
Phone: 206-533-6783
Email: sccfoundation@shoreline.edu
1964 Society Associate Faculty Professional Development Application
Due Date: November 3, 2017 at 5:00 p.m.
Amount to be Awarded: $1,100
Purpose:
The Shoreline Community College Foundation created the 1964 Society Associate Faculty Professional
Development Endowed Scholarship to provide funds in perpetuity for associate faculty to use toward their
professional development. This scholarship will also benefit the College and students by strengthening the
faculty in their various professional capacities. Professional development includes: attending conferences,
workshops, meetings or delivering presentations as a means to further their expertise in teaching at Shoreline
Community College.
Qualifications:
1. Associate faculty member at Shoreline Community College
2. Must have taught at Shoreline Community College for at least 2 quarters
3. Must be continuing as an associate instructor (as verified by Human Resources)
Important Information
1. Proposals will be reviewed by a selection committee including two Foundation board members and
three members of the Faculty Senate.
2. Recipients will be notified by December 1, 2017.
3. The Foundation may want to share the faculty member’s experience and request that all scholarship
recipients help disseminate their results by completing a brief report as soon as possible following the
project’s completion. Outcomes may be used in the College or Foundation materials, including the
website.
4. The following will not be considered for support: (1) meals; (2) software/hardware acquisition or other
equipment; (3) professional membership fees or licensure; (4) tuition; (5) additional faculty salaries
5. Please contact Mary Brueggeman with any questions – mbrueggeman@shoreline.edu
Only completed applications will be considered for support. Completed applications must include:
Complete application with signature
Itemized budget
Your answers to the 2 short essay questions – 250 words or less per question
Employment Verification form from Human Resources
Email the completed application and materials to mbrueggeman@shoreline.edu
or return to the Foundation
office in the Administration Building (1000), room 1005
PERSONAL INFORMATION
Name
Personal Address
City
State
Zip
Phone #
Cell
Day
Shoreline Email
Personal Email
Fund 252 – Shoreline CC 1964 Society Page | 2 Updated 10/6/17
16101 Greenwood Ave N
Shoreline, WA 98133
Phone: 206-533-6783
Email: sccfoundation@shoreline.edu
Faculty Name: ________________________________________________________________________________
EMPLOYMENT INFORMATION
Please select one:
Advising
Health Occupations/ Physical
Education/ Business
Library
Counseling Humanities Social Sciences
LC
N/CEO Workforce & STEM
Name of Department/Program:
Month/Year You Began Employment at Shoreline Community College:
SUPPORT REQUEST
What kind of professional development are you requesting support for?
* The following will NOT be funded: meals, software/hardware acquisition, professional membership fees or licensure, tuition, or
additional faculty salaries
Conference registration
Workshop
Meeting
Professional Association Presentation
Other
Other description:
Website URL for the conference or activity:
Applications for conference registration, a workshop, or a professional association presentation require the URL from the
event on the application
AMOUNT REQUESTED: $
Please answer the following 2 questions in 250 words or less.
1. Description of the professional development activity.
Other ____________________
Fund 252 – Shoreline CC 1964 Society Page | 3 Updated 10/6/17
16101 Greenwood Ave N
Shoreline, WA 98133
Phone: 206-533-6783
Email: sccfoundation@shoreline.edu
Faculty Name: ________________________________________________________________________________
2. Description of how the funds will further your professional development and/or teaching.
Clearly state the connection/benefit of request for funding to professional development and the
expected impact on student success, faculty success, and/or the campus community.
I acknowledge that this application is true and correct. I give permission for the Shoreline CC Foundation to
seek verification of the accuracy of any and all submitted information and documents. I also give permission to
the Shoreline CC Foundation verify my status and for the Shoreline CC Foundation to obtain information from
any program, department, and offices affiliated with Shoreline CC as it relates to my request.
Signature:
Date:
FOR COMMITTEE USE ONLY:
Awarded
Denied
TOTAL AWARDED: $
Notes:
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Shoreline community college 1964 Society Associate Faculty Professional Development Application

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Completed 15 January 2020

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