Professional Development Funding Requests
(2015-2016)
INSTRUCTIONS AND TIMELINE
The Professional Development Committee is accepting funding requests from all Chabot faculty,
classified staff, and administrators for the 2015-16 academic year to support professional evaluation
goals.
To request funding, please use the attached Professional Development Funding Request Form. The first
round of requests will be accepted until Friday, December 11, 2015. Your completed Request Form must
be submitted to any of the Professional Development co-chairs: Katrin Field, Ken Grace, Maria Ochoa, or
Rachael Tupper-Eoff. Prior to filling out the funding request form, please speak with your Dean/Area
Manager about other funding sources within your division or area.
There will be another opportunity to request funding in the Spring 2016 semester; however, we
encourage you to apply now as funds are limited.
Requests will be evaluated using the rubric provided on our website, and all applicants for this first
round will be notified of the status of their request by December 18, 2015.
PROFESSIONAL EVALUATION GOALS
If you have questions about what your student learning goals or professional evaluation goals are,
please speak with your immediate supervisor.
Evaluation forms can be found on the HR website, http://www.clpccd.org/HR/HRGovForms.php;
additional evaluation information can be found in the faculty and classified
contracts, http://www.clpccd.org/HR/HRContactsandSalarySchedules.php.
RETROACTIVE FUNDING FOR 2015-16
Because funding is only just becoming available, the Professional Development Committee would like to
accommodate anyone who may have attended a conference already this year. To qualify for
reimbursement, you must:
•
•
•
•
•
Have attended the conference on or after July 1, 2015
Have paid out of pocket
Have original receipts for all expenses for which you wish to be reimbursed
Be able to provide a copy of your Conference Leave Request
Be able to provide proof of attendance
You will need to fill out the Professional Development Funding Request Form; reimbursement requests
will only be accepted until December 11, 2015.
CHABOT COLLEGE
Professional Development Funding Request Form • 2015-2016
☐ Yes, I have spoken with my area Dean/Area Manager about all possible funding sources for
this request (Basic Skills, Equity, SSSP, division funds, etc.)
APPLICANTS
List all persons involved in this professional development opportunity. Include name and position for
each individual. Identify the primary contact person: _____________________________________
Other participants: ________________________________________________________________
_______________________________________________________________________________
TECHNICAL INFORMATION
Name of professional development opportunity _______________________________________
Location of professional development opportunity _____________________________________
Date(s) of occurrence ____________________ Date funds needed ________________________
Total Amount Needed ___________________ Amount Funded by Division/Area ____________
Amount Requested from Professional Development Committee ________________ ($500 max.)
Will you accept partial funding?
☐ Yes
Did you request funds in Program Review?
☐ No
☐ Yes
☐ No
Did you request funding from other sources? ☐ Yes ☐ No
If yes, where? _________________________________________
Were any funds allocated? ☐ Yes; amount: $____________ ☐ No
Write a brief summary of the professional development opportunity, including use of funds.
CONNECTION TO EVALUATION: Professional development must be tied to evaluative
measures specific to job functions. Please use the box below to answer the following question.
☐ Faculty: Which of your student learning goals/professional evaluation goals does this
support?
☐ Classified: Which category of your professional evaluation goals does this activity support?
☐ Administrators: Which of your professional evaluation goals does this activity support?
FINAL 11/24/15
IMPACT ON PROFESSIONAL GROWTH: Best practices for professional development and
growth involve collaboration and sustained support for the integration of new learning into
practice. Please answer the questions in the space provided below.
How do you plan to integrate the knowledge you’ve acquired through this opportunity in your daily
work? With whom on campus will you share this experience and knowledge? (check all that apply)
☐ Campus Presentation (Flex Day, presentation to students, etc.)
☐ Division/discipline meeting
☐ Written report to post on Professional Development website
☐ Community presentation (rotary, community engagement, etc.)
☐ Publish (please indicate publication: ______________________________ )
☐ Other: _______________________________________________________
BUDGET: Please provide a budget for this activity, including a breakdown of expenses. If you are
requesting to attend a conference, you also need to fill out and attach the Conference Leave: Request
Form (http://www.clpccd.org/business/documents/ConferenceLeaveRequest.pdf). You may use the
lines below or submit your budget report on a separate sheet (be sure to attach!).
Item(s)
Cost
_____________________________________________
___________________
_____________________________________________
___________________
_____________________________________________
___________________
_____________________________________________
___________________
I, _____________________, agree that by accepting Chabot College Professional Development funds
that I will apply the funds as specified in this application, integrate the knowledge I have acquired
through this opportunity in my daily work, and share this experience and knowledge with the
appropriate groups on campus as indicated above.
______________________________________
__________________________________
Print Name
Signature
_______________________
Date
FINAL 11/24/15