U N I V E R S I T Y O F H A W A I ‘ I A T H I L O PROFESSIONAL DEVELOPMENT FUND APPLICATION Applicant Name(s) __________________________ Department ___________________ Primary Contact Email __________________________ Phone _______________________ Name of Proposed Event ________________________________________________________ Please use additional space as necessary. 1. What categories best describe your project? Check all that apply: ____ Speaker ____ Training ____ Workshop ____ Technology ____ Audio Conference ____ Webinar 2. Provide a detailed summary of what you intend to do. Include when and where the event will take place. 3. What UH Hilo Strategic Plan goal does your proposed event address? Explain in detail how your event addresses that goal. 4. Who is your target audience and what is your anticipated attendance? What do you expect participants to gain from this event? Rev. 10/14 U N I V E R S I T Y O F H A W A I ‘ I A T H I L O PROFESSIONAL DEVELOPMENT FUND APPLICATION 5. How will you measure participation and how will you know whether the expectations proposed in #4 above were met? 6. Explain in detail how you will advertise this event to your audience. Are members of your target audience involved in the planning? Explain how or why not. 7. Utilizing one of the two samples provided, provide a budget summary detailing how you plan to use your awarded funds. To avoid a delay in the processing of your application, be sure that all budget items are directly related to the implementation of your event. Provide an explanation for items that may appear indirectly related. If you are proposing the purchase of food, please carefully read the section of the fund guidelines relating to food purchases before submitting your proposal. If you are requesting funding for travel, please carefully read the section of the fund guidelines relating to awards that include travel before submitting your proposal. ____ Budget Summary is attached. 8. Explain alternative options for supporting this proposal if it is not fully funded by the Professional Development Fund. Rev. 10/14 U N I V E R S I T Y O F H A W A I ‘ I A T H I L O PROFESSIONAL DEVELOPMENT FUND APPLICATION Professional Development Fund Application Agreement A signature from the awardee’s direct supervisor is required. If the awardee’s direct supervisor does not have approving authority, a signature from a Division Chair, Director, Dean, or Vice Chancellor from a unit willing to assume responsibility for fiscal administration of the award is required. Awardee is responsible for finding a unit that will be responsible for the fiscal administration of the award. Fiscal administration of the award includes identifying a support staff person trained in Kuali who will be responsible for all fiscal processing. It is the responsibility of the awardee and identified unit to work directly with the Business Office to ensure compliance with all University fiscal policies and procedures. All grant activity must be completed by the end date indicated on this application and a final report must be submitted within 30 days of the completion of the program or event. This report must include a copy of all invoices and/or receipts. All funded proposals will be posted on the Chancellor’s Professional Development website and any other internal media venues as deemed appropriate by the committee. By signing below, I acknowledge that the Chancellor’s Professional Development Committee shall in no way be held liable for any claims, damages, causes of action, or suits resulting from any activities of the awardee or its contractors. The awardee shall indemnify, defend, and save harmless the University of Hawaii at Hilo, the Chancellor’s Professional Development Committee, and their officers, agents, and employees from any liability, actions, claims, suits, damages, or costs arising out of or resulting from the acts or omissions of the awardee, its officers, employees, agents, or sub-contractors occurring during, or in connection with, activities that may be funded, in whole or in part, from Professional Development funds provided to the awardee under this agreement. ____________________________________ ___________________________________ Print Applicant Name & Department Signature ____________________________________ ___________________________________ Signature Date Print Direct Supervisor Name Date By signing below, I acknowledge that my unit has a Kuali-trained support staff person who will be assigned to assist with processing of all fiscal related activity for this award. ____________________________________ Print Division Chair, Director, Dean, VC ___________________________________ Signature Date Rev. 10/14