Professional Development Request Form

Section A: Employee Request

Name: __________________________________  Date: ___________________

Job title: ____________________________  Supervisor: ___________________

Check one:

[] Seminar   [] College Course   [] Workshop   [] Conference   [] other: ______________

Title of the activity: ___________________________________________________

School or organization name: ___________________________________________

Location: ___________________________________________________________

Dates of attendance: ______________________ Number of training hours: _______

Cost: $__________

What specific knowledge or skill will you learn? _____________________________________________________________________

______________________________________________________________________

How will the acquired knowledge or skill help improve your performance and/or prepare you for more advanced responsibilities? _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Employee signature____________________________________

Attach a description of the training with a completed registration form and forward to your supervisor for approval.

Section B: Approvals

Review and approve based on appropriateness, cost, scheduling, and quality of training.

Approved __________           Denied ________

If denied, provide an explanation: ___________________________________________

______________________________________________________________________

Supervisor signature: ______________________________ Date___________________

Division manager signature: ________________________   Date___________________

Human resources signature: ________________________   Date___________________

If approved, forward to accounting.

Section C: Registration and Payment

[] Check #_______   [] Purchase Order #_______   [] Credit Card____________________

Completed by: _____________________________________ Date_________________

Return this completed request form to Human Resources (HR) with payment attached. HR will return a copy of this request form and the original training registration form to the employee to complete the registration.