Professional Development Application

Name: _______________________________ Phone Ext.: _________ Date: ______________________

Department: __________________________ Supervisor: ____________________________________

Number of Years Employed by College of Saint Benedict: _________

Have you applied for professional development funds in the past? ______

Date(s) of Activity/Program: ________________ 

Location of Activity/Program: ____________________

Title or Description of Activity/Program:

(Must attach any written information you have on this activity/program such as brochures, registration forms, etc.) 

In what ways will you benefit from attendance at this proposed activity/program as an individual, as well as to enhance your performance on your job and to the community as a whole?

Expenditures Required to Attend Such Activity/Program:

Cost of Activity/Program:            $_______________

Travel Expenses:                        $_______________

Amount Paid by Department:        $_______________ (enter as negative number)

TOTAL AMOUNT REQUESTED:        $_______________

Type of Travel Expenses Incurred:  _____________________________________________

Employee Signature:  ____________________________________    Date:  _____________

Supervisor Signature:  ___________________________________     Date:  _____________

Support Staff Subcommittee for Professional Development Chair Signature:

______________________________________________________    Date:  _____________

Associate Director of Human Resources Signature:

______________________________________________________   Date:  _____________

Approved: _________  Denied: ________  Amount Approved: _________________

Business Office:  Please return form to Support Staff Subcommittee for Professional Development Chair.