CoJMC Staff Professional Development Request Form
CoJMC staff members requesting to participate in a professional development opportunity, please fill out the necessary information on this form for funding approval. Submission of this form serves as your required notification of your absence to Haley and, if needed, your application for travel funds.
Name
*
First Name
Last Name
Email
*
example@example.com
Type of Professional Development
Conference
Certification
Continuing Education Expense
Other
Title of Conference
*
Conference Address (Virtual or In-Person)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Conference Start Date
*
-
Month
-
Day
Year
Date
Conference End Date
*
-
Month
-
Day
Year
Date
Title of Certification
Certification Address (Virtual or In-Person)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Certification Start Date
*
-
Month
-
Day
Year
Date
Certification End Date
*
-
Month
-
Day
Year
Date
Continuing Education Institution
Description of Course/Courses
Expense Coverage Requested
Tuition
Books
Fees
Enrollment Semester
Spring
Summer
Fall
Description of Professional Development
*
Upload Published Professional Development Description (if applicable)
Browse Files
Drag and drop files here
Choose a file
(E.g. flyer, email, webpage screenshot)
Cancel
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How does participation in this professional development opportunity enhance your position at CoJMC?
*
(How will attending make you a better employee?)
How does participation in this professional development opportunity enhance your personal career progression?
Which professional development goals will be addressed by this professional development opportunity?
*
(E.g. leadership, improve time management, new skills)
Registration/Enrollment Fee
*
Travel Fees
Other Expenses
Total Cost Estimated
*
Submit
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