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Fpdc app1011

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  • 1. 2010 – 2011 Fiscal Year COLORADO MOUNTAIN COLLEGE APPLICATION FOR PROFESSIONAL DEVELOPMENT FUNDS I. This application must be completed for consideration for Professional Development Funds. Prior to completing this application, review the guidelines for specific requirements for the program to which you are applying. A separate application must be submitted for each funding request (not in excess of $1500). Be advised that an incomplete Application or an Application with an incomplete or missing Budget Summary will not be considered. Applications are being taken for events held in the United States. 1. Applicant Co-applicant (if applicable) 2. Campus Address 3. Home Address 4. CMC E-mail Phone: Work Home 5. Division/Department 6. Title/Rank of Applicant(s) 7. Proposed project/activity title. (List name of seminar, conference, workshop, or coursework). 8. Date of project/activity from to Month/ Day/ Year Month/ Day/ Year Page 1 of 4 Faculty Professional Development 2008/2009
  • 2. CMC Application for Professional Development Funds Budget Summary II. Prior to completing this form, review the guidelines for the funds to which you are applying. Complete only those sections that are applicable and specify the type of expenditure for each item. A separate budget summary must be completed for each cycle which funding is being requested. All expenditures must be itemized and justified. Be advised that an Application with an incomplete or missing Budget Summary will not be considered. Applicant’s Name Campus Date of Project/activity from to Month/Day/Year Month/Day/Year Amount Expenditures 1. Travel and related expenses a. Lodging @ $ /day x day(s) b. Meals @ $ /day X day(s) c. Transportation Specify d. Other Specify 2. Non-consumable supplies/materials/books Specify 3. Consumable supplies (e.g. paper, pens, postage, film) Specify 4. Registration fees for conference, seminar, internship, or workshop Specify 5. Other Specify TOTAL Attach any and all documentation that supports your proposal, including registration information, travel expenses and other costs. Failure to do so will result in denial of your application. Include additional pages if necessary. Page 2 of 4 Faculty Professional Development 2008/2009
  • 3. III. Using additional pages, answer each of the questions separately: 1. How will this activity align with the CMC mission and vision? 2. If you are attending a conference, indicate whether you are a presenter or participant. If presenting, please enclose a copy of your presentation abstract. 3. Explain the importance of the activity to your profession for which you are requesting funds. 4. Identify the objectives and potential benefits of the proposed activity. 5. Identify who is likely to benefit from your proposed activity. (students, others in the discipline, yourself, etc.) 6. What needs are being met by the proposed activity? (retraining, keeping current, etc.) 7. When, how and to what audiences do you plan to present your findings? IV. I have read the program guidelines and understand that only documented expenditures pursuant to the procedures described in those guidelines and approved by the Professional Development Funds Committee will be reimbursed. Applicant’s Signature Date FPDC Member Campus Representative Date The attached application has been reviewed and is approved: Campus CEO Date FPDC Chair (Central Services) Date V. Total No. of Pages in this Application: VI. Send SCANNED application and SCANNED attachments by the date specified in the committee/program guidelines to: Junella Montoya Colorado Mountain College 831 Grand Avenue Glenwood Springs, CO 81601 jmontoya@coloradomtn.edu Page 3 of 4 Faculty Professional Development 2008/2009
  • 4. Page 4 of 4 Faculty Professional Development 2008/2009