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Professional Development Award Application (Spring 2021)
for Administrative Professional (AP) and State Classified (SC) Employees--Applications due February 26, 2021 (11:59 pm MST)
Personal/Employment Information
Name
*
First
Last
Email
*
Phone
*
Department/Unit Name
*
Department
Dept. Number/Address
Employee Type (check one):
*
Administrative Professional
State Classified
Total Years at CSU
*
Include all years as AP and SC. Note that you must have been employed for one full year prior to the date of the professional development event.
Awards in the last two years
*
Have you received any professional development funds through this award in the last two years?
Yes
No
Supervisor's Email
Fiscal Officer's email
Professional Development Information
Description
*
1. Describe the professional development activity you are pursuing. Related documents may be uploaded at the end of this form.
Relation to employment
*
2. Describe how this professional development opportunity relates to your current position at CSU.
Benefit to Department
*
3. How will this development opportunity benefit your department?
Start Date
*
Date Format: MM slash DD slash YYYY
End Date
*
Date Format: MM slash DD slash YYYY
Have you already registered for the activity? (check one)
*
Note a “Yes” does not ensure funding via this award.
Yes
No
Do you plan to attend/participate regardless of possible funding through the Professional Development Award?
*
Yes
No
Should you only receive part of the funding you have requested, briefly explain how that may impact your likelihood of participating in the proposed activity.
Amounts being requested.
Enter 0 if not applicable.
1. Registration
*
2. Other Expense
*
Description and break down of other expenses
Total
3. Available funding from your Department
*
As indicated by my signature below, I have provided accurate information on my application form and am eligible and willing to meet the terms outlined in the “Award Eligibility Criteria.” Additionally, I certify I have discussed with my supervisor and department's fiscal officer and am approved for this professional development opportunity, including any department cost share, if awarded.
*
Sign by typing your name
Date
*
Date Format: MM slash DD slash YYYY
Attach a File
(e.g., a conference brochure, proof of registration, etc.)
Email
This field is for validation purposes and should be left unchanged.
