Faculty/Staff Professional Development Form

Please complete all required fields. Funding is subject to availability.

Faculty/Staff Name(Required)

Email(Required)

Professional Development Dates(Required)

Professional Development Destination(Required)

Please include the city and state of the destination

Description of Professional Development Activity(Required)

Desired Goals of Activity(Required)

Explain how you plan to use and share the information that you learn from this activity(Required)

How will this activity positively impact SAU?(Required)

Name of Conference / PD Event(Required)

Link to conference/event website(Required)

Will students be participating?(Required)

Yes

Will you be presenting?(Required)

Yes

Will students be presenting?(Required)

Yes

What are the topics of the presentation(s)?

If applicable

List your most recent professional development experience that was funded by SAU/SAU Foundation(Required)

How does this activity differ from previous activities funded by SAU/SAUF?(Required)

Travel Budget – Expenses

Transportation via(Required)

For example: airplane, car, etc.

Transportation Cost(Required)

Lodging – Number of Rooms Needed(Required)

Lodging – Number of Nights(Required)

Lodging – Rate per Night(Required)

Lodging Total(Required)

Registration – Number of Registrants(Required)

Registration – Fee per Person(Required)

Registration Total(Required)

Food – Number of People(Required)

Food – Number of Days(Required)

Food – Rate per Person per Day(Required)

Food Total

Additional Funding Support

Other – Description of funding needed 1

Other – Amount 1

Other – Description of funding needed 2

Other – Amount 2

Other – Description of funding needed 3

Other – Amount 3

Total estimated cost

Additional Funding Support

Include other sources of funding you have secured (do not include funds you are requesting through the Foundation)

University Departmental Funding (Additional Support)

For example: Music department, Engineering department, etc.

Additional Funding – Total

For example: personal fundraising, other academic grants/scholarships, etc.

Balance Remaining

Funding Request(Required)

Approvals & Accounting

Faculty/Staff signature(Required)

Date Signed (Faculty/Staff Member)(Required)

Dean signature(Required)

Date (Dean)(Required)

Account number for transfer of funds(Required)

IMPORTANT: Financial Services cannot transfer funds into the above account until all travel permits (if applicable) are completed and on file