Middlesex Community College

Professional Development Proposal Application

PD Funding For Course Work/ Course Materials

Applications related to course work/course material (books, educational media) should be submitted three weeks prior to the beginning of the course. If requesting PD funds for course material, it is recommended that you first check with the college librarians about the possible availability of books or media through library services.

Approved applicants receive reimbursements for the course materials after submitting a receipt. Reimbursements for coursework are processed after submitting proof of course completion with a passing grade.

 

Date of Submission:

Name:

Job Title:

Department or Division Name:

Supervisor:

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):

Proposed Activity or Project - Name of activity, course(s), conference, date(s) and location:

Purpose of Activity or Project, including the relationship to the college's strategic directions - 1 to 3 paragraphs:

Anticipated Outcome and Follow-up:

For Books/Materials for Curriculum Research and/or Development

Titles, Publishers and Addresses: