Administrative Association 2019 - 2020

Professional Development Funding Request Form

Administrator Professional Development Funds are available within a given fiscal year, which begins July 1, 2019 and ends June 30, 2020. Additional forms may be required by your supervisor, Human Resources and/or Finance such as BPA, HR-78 and HR-79. Activities MUST be completed and reimbursement forms submitted prior to June 1, 2020. Professional Faculty applicants must exhaust all other professional development funding sources prior to submitting a request.

If you have any questions, please email dfaulks-brayboy@tcc.edu.

Select the term of the fiscal year:*

Name*

Prefix

First

Last

Suffix

Email*

Select your campus*

Select your total years of experience as a TCC administrator.*

Select your level of activity in the operations of the Administrative Association*

Please Explain

Check the most recent year in which Association funds were previously awarded to you*

If you received Association funds in previous years, describe ALL activities including YEARS and AMOUNTS awarded.

Preconditions (Submitted Forms and Exhausted Funds)

Will you submit the online request form for travel and/or membership?*

If you are applying for education assistance funding, related to either degree completion or job related course enrollment, please complete the forms applicable to your enrollment. These forms are found on the HR SharePoint URL under Training and Development.

Professional Development Activity:

Select the type of professional development activity.*

If multiple requests will be submitted for this fiscal year, rate the priority level for this request.

Describe the activity including the name of the activity and sponsoring organization.

Dates, Costs, Available Funds

Enter the activity's date*

End:*

Enter amount of funds requested to cover:

Membership dues:

Tuition:

Conference/workshop registration:

Airfare:

Lodging:

Costs not shown above:

Enter the total amount of funds being requested.

Total Funds Requested

What are the anticipated benefits of this activity to the applicant, to the College, and to the profession?*

Is there any additional information that you would like the Professional Development Funds Committee to know about your application?*

Attestation

I verify that I have reviewed and am in compliance with the applicant guidelines and requirements contained in this application and on the Administrative Association website. I agree to electronically submit a report to the Administrative Association within 30 calendar days of the activity's completion date (as listed on this application) which contains an overview of the professional development activity and the value-added benefits to the recipient, the College, and my profession. I agree to make an oral presentation on the value-added benefits to the recipient and College to the Administrative Association during a scheduled meeting within 6 months of the activity's completion date. I agree to notify the Association Chair, immediately in writing, of any changes to the approved activity such as level of participation and projected costs, which may allow other members to receive monies. I agree to submit a copy of the completed travel/ reimbursement form to the Association Chair within 30 calendar days of the activity's completion, which will allow the Association to maintain accurate records of disbursed funds.

I agree to the conditions provided in the attestation statement shown above.*

Type the characters from the image below