Professional Development Request

Required

Namerequired

First Name

Last Name

Email Address

Department/Position

Request For:

Faculty Study Grant

Presidential Grant

Benedum Conference Fund (Continuing Education Grants)

How does this experience promote one or more of the following unique points of value: Relational Teaching, Real World Learning, Balanced World View?

What degree do you currently hold?

How many credit hours beyond the degree have you completed?

What institution do you plan to attend?

Please list the course name(s) and tuition(s) to be covered by the grant.

If any of the above courses are being taken as part of an advanced degree program, please explain.

Please indicate briefly, for each course, how the information gained therein relates directly to your current or projected responsibilities at Shady Side Academy.

Describe the opportunity for which funding is requested, including the professional benefit you expect to derive and how you expect to share that benefit with your students.

Explain why this opportunity cannot be funded by other Academy professional development programs.

List the costs associated with this opportunity.

(Item, Cost)

Title of the Conference or Workshop

Hosting Organization

Date(s) and Time(s)

Location

Provide a brief description of the content of the conference or workshop and how it will enhance your work at Shady Side Academy.

List the individual and total costs associated with this opportunity.

Per diem, mileage, airfare, Uber, tolls, parking, etc.)

Please provide a brief description of how you plan to share the newfound knowledge obtained from this opportunity with the Shady Side Academy community.

Upload any pertinent conference information or tuition bills

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School Name

Professional Development Request

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