INDIVIDUAL PERSONAL AND PROFESSIONAL DEVELOPMENT

Conferences/Workshops

SHOLARSHIP APPLICATION

NOTE:  These funds are provided by the Classified Professional Development Team, and are not bargained funds.

Please print this page and then fill in the information, or copy and past this page into a word-processing program.
 

Term for which funds are being requested:  Fall                Winter                Spring 

Name ______________________________      Date ______________________

Department __________________________     Phone _____________________

Name of Event (for which coverage is required) _________________________________________________________ 

Date of Event _____________________    Location of Event _____________________

Reason coverage is required -

___________________________________________________________________________________________________

___________________________________________________________________________________________________

 

Supervisor's Signature ______________________________

 

I agree in the event that funds have been paid by Lane Community College, I am obligated to attend the workshop/conference described in this application.  I understand I am financially responsible for the repayment of funds if I do not attend the funded activity

___________________________                         _______________
                  Signature                                      Date

Please submit 1 copy of completed form & 1 copy of supporting documentation to: 

Colby Sheldon, International/MultiCultural Services, Building 1 - 201b, ext 5165, sheldonc@lanecc.edu

Date received ______________ Approved/declined ________________ 

Notified applicant ___________