Faculty Professional Development Grant Application

Faculty Professional Development Grant Application

Please complete the application and email it to the Faculty Development Committee or fax it to Lezli Redmond at (608) 287-2497.

Your Name____________________________________________ Today’s Date____________________

Describe the professional development activity (attach brochure or other program documentation):

Dates and location:

Brief explanation of why this is important and how it will improve your effectiveness:

1-5 points (not important to extremely important)

How does this relate to the needs of the program?

1-5 Points (not at all to very much)

How will you share your knowledge with others?

1-5 points

Total amount requested:

Local/regional additional 2 points

Matching funds additional 3 points

Approximate breakdown of costs (eg training or meeting costs, travel, accommodations, meals):

Max of 20 points

November 22, 2010