Professional Development Application FY 21

Please fill in a valid value for all required fields

Please ensure all values are in a proper format.

Are you sure you want to leave this form and resume later?

Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form.

You must upload one of the following file types for the selected field:

There was an error displaying the form. Please copy and paste the embed code again.

There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue.

The following eligibility criteria apply to employees who wish to participate in this component of the program:

Employee must have a minimum of one year of full-time employment at Morehouse College.
Employee must be in permanent full-time pay status during the completion of the activity for which support is requested.
Employee must explain clearly how the professional development opportunity will be beneficial in helping Morehouse College achieve its strategic goals and initiatives; improve its programs and services; or enhance student learning at Morehouse College.

Professional Development Type*

On-Campus (Requires a minium of six people) Off-Campus

Will more than one employee be attending the same training / workshop?

Yes No

Professional Development Application FY 21 On-Campus

Are you a supervisor?*

Yes No

Will the trainer be an indiviual consultant?

Yes No

Please CLICK HERE to download the Independent Contractor Form

Please upload the listed items with your completed application:

Resume/ CV of consultant/ presenter/ trainer*

No File Chosen

File uploads may not work on some mobile devices.

Vendor Application and W-9

No File Chosen

File uploads may not work on some mobile devices.

Independant Contractor Form*

No File Chosen

File uploads may not work on some mobile devices.

Name of Requestor*

First Name

Last Name

Title of Requestor*

Academic Department/ Program*

Email*

Title of Proposed On-Campus Activity/ Program*

Proposed Date of Activity/ Program*

Location of Activity/ Program*

Rationale for proposed project/ activity*

Provide a summary of the needs assessment (if conducted) and attach a copy OR attach a copy of the proposed survey instrument(s), assessment tool(s), or Questionnaire(s) to be used:

No File Chosen

File uploads may not work on some mobile devices.

Describe your target group*

Anticipated # of Morehouse Faculty/ Staff participants*

Other Faculty/ Staff (if applicable)

List of objectives of the Proposed On-Campus Activity*

List the expected outcomes (benefits, improvements, impact, etc.) in measurable terms*

Describe how you will evaluate the proposed activity and determine its positive impact*

Funds requested:

Requested Expenditure Description

Amount-1 $

Requested Expenditure Description

Amount-2 $

Requested Expenditure Description

Amount-3 $

Requested Expenditure Description

Amount-4 $

Requested Expenditure Description

Amount-5 $

Requested Expenditure Description

Amount-6 $

Total Amount Requested $

As Requestor, my signature affirm that I am aware of the polices and procedures associated with the receipt of Title III Part B funds to support this activity/ project and my agreement to adhere to them.

[clear]

Use your mouse or finger to draw your signature above

Professional Development Application FY 21 Off-Campus

Employee must have a minimum of one year of full-time employment at Morehouse College.

Employee must be in permanent, full-time pay status during the completion of the activity for which support is requested.

The maximum number of funded off-campus professional development opportunities per participant is two (2) per grant year.

PLEASE NOTE: Each person is allotted up to $4000 per year for training related expenses.

Are you a supervisor ?*

Yes No

Will you be presenting at the conference/ workshop?*

Yes No

Please upload the listed items with your completed application:

A signed letter of recommendation from your Supervisor*

No File Chosen

File uploads may not work on some mobile devices.

Detailed information about the professional development opportunity*

No File Chosen

File uploads may not work on some mobile devices.

Agenda, Course Description, or Class Schedule from event website

Employee Name*

First Name

Last Name

Title*

Department*

Employee Email*

Supervisor Email Address*

Amount Requested: $

Activity to be Supported:*

Professional Development Other

(check one)

Type of Professional Development (Specify workshop, seminar, etc.)*

Please Specify

Date of departure*

Date of return*

Location(s)*

List the expected outcomes (benefits to Morehouse College, improvements, impact, etc.) in measurable terms:*

Describe how you will evaluate the proposed activity and determine its positive impact:*

Funds requested:

PLEASE NOTE: Each person is allotted up to $4000 per year for training related expenses.

Please itemize your request and include supporting documentation, quotes, etc.

No File Chosen

File uploads may not work on some mobile devices.

Requested Expenditure Description

Amount-1 $

Requested Expenditure Description

Amount-2 $

Requested Expenditure Description

Amount-3 $

Requested Expenditure Description

Amount-4 $

Requested Expenditure Description

Amount-5 $

Requested Expenditure Description

Amount-6 $

Total Amount Requested* $

Maximum Amount Can Not Exceed $4,000

As Requester, my signature affirms that I am aware of the policies and procedures associated with the receipt of Title III/Part B funds to support this activity/project and my agreement to adhere to them.

Requester Signature*

[clear]

Use your mouse or finger to draw your signature above

Date*

Approval Status

Approved Denied

Professional Development Application FY 21 Off-Campus (GROUP)

Employee must have a minimum of one year of full-time employment at Morehouse College.

Employee must be in permanent, full-time pay status during the completion of the activity for which support is requested.

The maximum number of funded off-campus professional development opportunities per participant is two (2) per grant year.

PLEASE NOTE: Each person is allotted up to $4000 per year for training related expenses.

Are you a supervisor ?*

Yes No

How many employees will be attending?*

Will anyone in the group be presenting at the conference/ workshop? *

Yes No

Please upload the listed items with your completed application:

A signed letter of recommendation from your Supervisor*

No File Chosen

File uploads may not work on some mobile devices.

Detailed information about the professional development opportunity *

No File Chosen

File uploads may not work on some mobile devices.

Agenda, Course Description, or Class Schedule from event website

Employee Name*

First Name

Last Name

Title*

Department*

Employee Email*

Supervisor Email Address*

Amount Requested: $

Activity to be Supported: *

Professional Development Other

(check one)

Type of Professional Development (Specify workshop, seminar, etc.)*

Please Specify

Date of departure*

Date of return*

Location(s)*

Upload a document listing the expected outcomes (benefits to Morehouse College, improvements, impact, etc.) and describe how you will evaluate the proposed activity determining its positive impact in measurable terms (per participant):*

No File Chosen

File uploads may not work on some mobile devices.

Funds requested:

PLEASE NOTE: Each person is allotted up to $4000 per year for training related expenses.

Upload all itemized requests and supporting documentation, quotes, etc. per participant*

No File Chosen

File uploads may not work on some mobile devices.

This can be a Word or Excel document

Requested Expenditure Description

Amount-1 $

Requested Expenditure Description

Amount-2 $

Requested Expenditure Description

Amount-3 $

Requested Expenditure Description

Amount-4 $

Requested Expenditure Description

Amount-5 $

Requested Expenditure Description

Amount-6 $

Total Amount Requested* $

Requester Signature*

[clear]

Use your mouse or finger to draw your signature above

Date*

Approval Status

Approved Denied