Complete this form and submit eight copies to Don Peterson, IACC 206. Mini project applications are due by the first of the month and applicants will be notified concerning the funding decision by the fifteenth of the month.
Name _____________________________________________ Date _______________________ Position Title ________________________________________________________________ Department/Unit _______________________________________________________________ Address _______________________________________________________________________ Phone Number _____________________ E-mail _____________________________________
2. Describe how the activities will improve your ability to per-form your duties.
3.List budget items with anticipated costs and brief explanations of how each item relates to the professional development activity.
Item Explanation Amount ______________ ___________________ $______________ ______________ ___________________ $______________ ______________ ___________________ $______________ ______________ ___________________ $______________ ______________ ___________________ $______________ ______________ ___________________ $______________ TOTAL AMOUNT $______________4.Indicate other sources of funding (if applicable).
Applicant's Signature __________________________________ Date ________________ Dept./Unit Head's Signature ____________________________ Date ________________