Middlesex Community College

Professional Development Proposal Application

Important: Please read the entire form before filling it out.

Qualifying for Conference/Workshop Funds

Applicants must confirm that this request for PD funding has been discussed and approved by their division dean.

Please note: if funding is approved, the purchasing transactions/arrangements must be handled through our office in accordance with college policy.

Proposal Submission Timeline

To allow time for the Office of Professional Development to review the application, and for the Purchasing Department to make arrangements for payment, we have set the following funding request deadlines:

-  For any request that involves air travel, employees seeking Professional Development funds should submit an application at least one month prior to the event.

- For any PD request that does not require air travel, the proposal must be submitted at least three weeks before the event.

Purchasing Arrangements

If funding is approved, the purchasing transactions/arrangements must be handled through our office in accordance with college policy. This means that all travel arrangements and hotel arrangements must be arranged by Idania Coa Cepeda our administrative assistant. Do not do your own booking, even if you have an active profile in the college's American Express system.We do not provide reimbursements for travel/conference arrangements that were handled on your own. Reimbursement forms for meals & gas accrued during conference travel should be forwarded to Idania Coa Cepeda for review and Peter Shea's signature.

Reimbursement forms for meals, transfer costs & gas accrued during conference travel should be forwarded to Idania Coa Cepeda for review and Peter Shea's signature.


Required Workshop/Conference Feedback

In order to share your conference experience and takeaways with MCC colleagues who might consider attending the same conference, all conference travel funding recipients must complete this brief conference evaluation form.  This information will be posted on the MCC PD Blog.

PLEASE NOTE: In situations in which more than three applicants submit proposals for the same conference requiring extensive travel and overnight accommodations, the equivalent of three applicants expenses will be funded. This amount can then be used by the entire group of applicants, as a pool of funds to use amongst themselves.

Please contact Idania Coa Cepeda at Ext. 3527 for questions or information.

 

Date of Submission:

Name:

Job Title:

Department or Division Name:

Division Dean who approved this request:

Campus and Building Location:

Phone Extension:

Full Time or Part Time?

Full Time    Part Time

Please indicate your employment classification for your primary role at the college

MCCC
NUP
AFSCME
Part-Time Non-Unit Employee
DCE

Date of Hire (month/year):


What is your intended target date/time of day for Departure?


What is your intended target date/time of day for Return?


What airport do you plan to leave/return from?


What airport do you plan to arrive at?

Please provide lodging information (location of hotel/dates of stay)

To Attend a Conference or Workshop

Web Address for Conference (If applicable. Do not include the http:// portion of the web address.):

Registration Fee:

Are you traveling solo to this conference or as part of a group?

Solo    Part of a group

Transportation*

Mileage* (travel by car - # of Miles X .54 a mile):

Tolls:

Hotel (include tax)** :

Meals (per state allowance of $7.50 Breakfast, $12.50 Lunch, $20.00 Dinner) - # of meals X cost:

Total Amount Requested:


*Air travel arrangements must be made through Ping Guo, x3508, Business Services, Cataldo Building, Bedford Campus. She also can provide the number of miles to and from destination points for auto travel.

** In most cases funds for hotel accommodations within 75 miles of campus will not be awarded.

  You acknowledge that you have read and understood the terms of this form.