16101 Greenwood Ave N
Shoreline, WA 98133
Phone: 206-533-6783
Email: sccfoundation@shoreline.edu
1964 Society Faculty Professional Development Application
Due Date: November 9, 2018 at 5:00 pm
Amount to be Awarded: $1,100
Purpose:
The Shoreline Community College Foundation created the 1964 Society Faculty Professional Development
Endowed Scholarship to provide funds in perpetuity for 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. For 2018-2019, must be an 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 Resource on the Employment
Verification Form)
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, 2018.
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 Karla Belmonte with any questions kbelmonte@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 questions250 words or less per question
Employment Verification form from Human Resources
Email
the completed application and materials to kbelmonte@shoreline.edu
or return to the Foundation office
in the Administration Building (1000), room 1005
PERSONAL INFORMATION
Name
Employee ID
Personal Address
City
State
Zip
Phone #
Day
Evening
Shoreline Email
Personal Email
Fund 252 Shoreline CC 1964 Society Page | 1 Updated 9/26/2018
Fund 252 Shoreline CC 1964 Society Page | 2 Updated 9/26/2018
16101 Greenwood Ave N
Shoreline, WA 98133
Phone: 206-533-6783
Email: sccfoundation@shoreline.edu
EMPLOYMENT INFORMATION
Please select one:
Advising
Health Occupations/ Physical
Education/ Business
Library
Counseling Humanities Workforce & STEM
LCN/CEO
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.
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
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:
Faculty Name: _______________________________________ Employee ID # _____________________________
* See items NOT allowed under Important Information, #4 on page 1.