PLEASE SUBMIT ELECTRONICALLY TO YOUR DEAN
Revised SL30029
04/06
WINONA STATE UNIVERSITY
APPLICATION FOR PROFESSIONAL IMPROVEMENT FUNDS
IFO
REFERENCE: AGREEMENT BETWEEN STATE UNIVERSITY BOARD AND INTER-FACULTY
ARTICLE 19, AND WSU REGULATION 3-11
PLEASE COMPLETE ALL INFORMATION REQUESTED
SEMA4 EMPLOYEE ID #
DATE REQUESTED:
NAME OF APPLICANT
DEPARTMENT:
HIGHEST EARNED DEGREE:
DATE DEGREE EARNED:
ACADEMIC RANK:
PROJECT CATEGORIES:
Criterion 1:
Criterion 2:
Criterion 3:
Criterion 4:
Criterion 5:
PDP:
Explain how this proposal relates to each criterion selected, to your professional development
plan, and to the department’s and university’s mission/goals.
PROJECT TITLE:
Describe your project.
BEGINNING AND ENDING DATES FOR PROJECT COMPLETION:
(MUST BE WITHIN THE APPROPRIATE FISCAL YEAR - JULY 1 - JUNE 30)
TOTAL FUNDS REQUESTED:
**************************************************************************************************************
DEAN'S RECOMMENDATION:
VICE PRESIDENT’S RECOMMENDATION:
PRESIDENT’S RECOMMENDATION:
PROPOSAL FUNDED AT:
$
PROPOSAL NOT FUNDED
(PAGE 1 OF 2)
SL 30029
Ref: WSU Reg 3-11
BUDGET REQUEST: Complete using categories that apply and adding others as appropriate.
Provide an explanation/justification for each line item for which funding is requested.
$
Student Help - Explanation:
Travel In-State - Explanation:
Travel Out-State - Explanation:
Registration Fees-Conferences, and Seminars (No Credit) - Explanation:
Tuition and Fees-Projects Granting College Credit - Explanation:
Books And/Or Supplies - Explanation:
Equipment - Explanation:
Audiovisual Supplies - Explanation:
Printing: On Campus - Explanation:
Office Supplies - Explanation:
Postage - Explanation:
Computer Service Charges - Explanation:
Copy Machine Fees - Explanation:
Other - Explanation:
Other - Explanation:
Other - Explanation:
Other - Explanation:
$
TOTAL REQUESTED
_____________________________________________
SIGNATURE OF APPLICANT
(Page 2 of 2)
Ref: WSU Regulation 3-11 Revised 12/29/05
SL 30031
WINONA STATE UNIVERSITY
REPORT FOR USE OF PROFESSIONAL IMPROVEMENT FUNDS
IFO
GRANT RECIPIENT:
Today's Date:
DATE(S) OF PROJECT:
Brief Description of Project:
Comment on Completion of Project Goals and Objectives and Impact on Winona State
University:
ROUTING: Dean_____ Vice President_____ President_____