Professional Development Grants
Staff Form	
		
Applicant Name/Program Area:		
		
Proposal Description		
Dates/Location of attendance	 	

State Vehicle Requested:                   

Amount Requested (Max $500)	 	
		
Expense Detail:		
(Provide a brief budget & include
applicable per diem rates for meals)	 	
	 	
Total Expenses	 	

Are you using:     Travel Card?__________  Procurement Card?____________ NET Card?________________

** Your Travel Request must be attached to this form before submission to Supervisor.**

Have you requested any other campus or state funding besides this grant request? If yes, please provide details:

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Benefit (Where appropriate):	
Self	 	
Students	 	
Program Area	 	
College	 	

Applicant’s Signature/Date	 	

Supervisor's Signature/Date