HomeStaff AssociationProfessional Development Funding Application Staff Association Professional Development Funding Application Professional Development Funds Application Request Type * Individual Group A group can entail a maximum of four (4) employees per department. Personal Information First Name * Last Name * Digital ID * Department * Starting Date at Utah Tech * Group Information 2nd Member's First Name * 2nd Member's Last Name * 2nd Member's Digital ID 3rd Member's First Name 3rd Member's Last Name 3rd Member's Digital ID 4th Member's First Name 4th Member's Last Name 4th Member's Digital ID Event Details Professional Development Event * Event Starts * Event Ends * Location of Event * Requested Funding Requested Costs are per * Individual Group Total Cost of Opportunity * (Travel, fees, meals, etc.) Department Contribution * (Responsible for a minimum of 25% of total cost) Requested Amount * (Maximum of $750 per applicant) Benefits of Attending Event Describe how the activity relates to current job responsibilities and duties, increases individual productivity and job skills, or in some other way enhances the value or contribution of the employee(s) to the University. * This activity will also allow me to: (check all that apply) * Maintain licensure or certification in my current field Present at a professional conference or workshop (local, regional, or national) Attend/participate in a professional conference or workshop (local, regional, or national) Complete other professional objectives as determined by my supervisor. Other Other (briefly explain below) Would you be able to participate in this professional development opportunity in the event that you do not receive staff professional development funds? * Yes No Required Approval Budget Administrators Email * If you are the Budget Administrator for the department you must add your supervisors email for approval. Index Code * Would you like a copy of this form to be sent to your email? Yes No Email Address * By adding my name I am agreeing to provide my supervisor and the Professional Development Committee with the required documentation and information as outlined above. Applicants Signature * Radio Buttons Option 1 Option 2 If you are human, leave this field blank. Submit
