Professional Development

APPLICATION FOR PROFESSIONAL DEVELOPMENT

Professional Development Guidelines: •AFSCME •Management •SCUPA

WORK GROUP *

AFSCME

SCUPA

MANAGEMENT

TYPE OF REQUEST * 🛈

CATEGORY I - INDIVIDUAL STUDY GRANT

CATEGORY II - FUNDING ASSISTANCE

NOTE: UNDER CATEGORY I INDIVIDUAL STUDY GRANT, THE GRANT WILL BE DISBURSED ON A REIMBURSEMENT BASIS FOR ACADEMIC COURSES. THE INDIVIDUAL MUST RECEIVE A GRADE OF “C” OR BETTER FOR UNDERGRADUATE COURSES OR A GRADE OF “B” OR BETTER FOR A GRADUATE COURSE. REQUEST WILL BE RETURNED IF IT IS NOT A CREDIT BEARING COURSE. SELECT CATEGORY II FOR FUNDING ASSISTANCE FOR CERTIFICATIONS, TRAINING, WORKSHOPS, ETC.

TYPE OF FEES * 🛈

REGISTRATION

TUITION

IS THIS REQUEST FOR A GRADUATE LEVEL COURSE? *

Yes

No

DOWNLOAD IRS QUESTIONAIRE (for graduate level courses only)

Please have your approval form (travel form, graduate course IRS tax form, OR check requisition, etc) approved and ready to upload prior to
completing this request. YOU WILL NOT BE ABLE TO SAVE AND RETURN TO COMPLETE.

EMPLOYEE FIRST NAME *

EMPLOYEE LAST NAME *

YOUR EMAIL ADDRESS *

EMPLOYEE POSITION TITLE

DIVISION *

DEPARTMENT *

REQUESTING AMOUNT * 🛈

AFSCME REQ AMOUNT * 🛈

SCUPA REQ AMOUNT * 🛈

COST CENTER * 🛈

GLA * 🛈

START DATE * +

END DATE * +

SEMESTER (FOR INDIVIDUAL STUDY GRANT ONLY) *

COURSE NUMBER/SECTION *

COURSE OR CONFERENCE NAME *

INSTITUTION OR SPONSORING ORGANIZATION NAME *

1. BENEFIT TO THE UNIVERSITY (please describe) *

0/800 words

2. IMPROVEMENT/RELATIONSHIP ON THE DELIVERY OF SERVICE (please describe) *

0/800 words

3. PROFESSIONAL SKILL ENHANCEMENT (please describe) *

0/800 words

NOTE: REQUEST MIGHT BE RETURNED IF THERE IS NO REFERENCE MATERIALS (LINK OR ATTACHMENT) TO THE CONFERENCE, SEMINAR OR COURSE.

4. INCLUDE A LINK TO THE CONFERENCE, SEMINAR OR TRAINING IF APPLICABLE.

4. ATTACH A BROCHURE OR EVENT MATERIALS (if applicable)

4. ATTACH BROCHURE/COURSE OUTLINE AND COURSE REGISTRATION MATERIALS *

5. ATTACH APPROVAL FORM * 🛈

6. ATTACH COMPLETED IRS QUESTIONAIRE FROM LINK ABOVE * 🛈

EMPLOYEE'S SIGNATURE *

clear

TODAY'S DATE * +