CLACKAMAS COMMUNITY COLLEGE APPLICATION FOR PART-TIME FACULTY PROFESSIONAL DEVELOPMENT FUNDS (PDF) Your answers must be typed to be accepted!

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Overview The part-time faculty association is allotted money every year to reimburse part-time faculty 1 for professional development events commencing no earlier than the term you start teaching at CCC. You can apply for a maximum of up to $700 per academic year (depending upon available PDF funds 2 ), but you may include all reimbursable amounts. This money can be used for almost anything that helps further your academic knowledge, including, but not limited to: Conferences or workshops Classes at other institutions Professional memberships Periodicals directly related to an instructor's teaching If any event is not on this list, prior approval must be received from the PDF Committee. When attending an approved event, the Professional Development Fund (PDF) will reimburse for: Registration or Dues Travel o Includes airfare, train, bus, public transit (metro) and shuttles o Rental cars will be covered if you verify that the event is not located near a major city or airport. We will not cover gasoline for the rental. o We will not cover taxi rides unless you can show there is no type of shuttle or public transport system Lodging 3 o Cannot exceed government rates, http://www.gsa.gov/perdiem o In addition to the length of the event, we will cover the lodging for the night before the event and the night of the last day of the event Mileage for events to which you drive your personal vehicle o The amount of reimbursement is specified on the travel voucher o You need to include a map verifying the mileage driven Some Meals o Whether meal will be reimbursed and which meals are reimbursable depends on your trip. Refer to the attached Meal Flowchart diagram to see what you can be reimbursed for. Some trips will require receipt submission, others will not. What we will not pay for is hardware, software, magazine/newspaper subscriptions unrelated to an instructors' teaching subjects, nor supplies of any sort for personal projects (supplies required for approved classes or workshops up to $100 is allowable.) If you have questions about whether an event would be covered by PDF, please contact someone on the committee or the committee chair Chris Dreger. cdreger@clackamas.edu Remember, you can submit a reimbursement application only after the event has occurred. You should have attended the event within the last six months. Only completed applications will be considered. Read the application and instructions carefully so that 1 To qualify for this reimbursement, you must have worked at CCC for two terms of the academic year (July to June).. 2 The amount available is dependent on the number of PTFs who apply for the fund. We cannot guarantee that you will receive any reimbursement in any given term or year. If, on the other hand, there is a surplus of funds at the end of Spring term, those with claims over the $700 limit may be reimbursed further, on an equal basis, up to the amount of funds available at that time. 3 Only events over 60 miles away will be reimbursed for lodging. updated 10/3/2018 Page 1 of 7

your claim is not rejected. We only process applications once a term. Applications for reimbursement for Fall, Winter and Spring terms must be submitted by the 8 th week of the term. Applications for reimbursement for Summer term must be submitted by the 7 th week of that term. Once an application is approved, you will be contacted by a member of the committee. Approved applications are given to Human Resources to process. Once the applications are sent to Human Resources, it can take several weeks to process. If you have any questions, contact: Chris Dreger -- cdreger@clackamas.edu voice mail: 503-594-3642 Application begins on the next page updated 10/3/2018 Page 2 of 7

Name: Department: Email: PDF Event and Location: Date(s) of Event: A. General Budget Outline (Don t forget to also turn in a Travel Voucher) * Registration fee: Travel cost Lodging cost Lodging cost must not exceed government rate: http://www.gsa.gov/perdiem Meals Refer to attached Meal Flowchart Other: (Specify) TOTAL** *If only seeking reimbursement for course fees, books, memberships or conference fees, this same process must currently be followed. **A maximum of $700 per academic year is allowed. **Must match total amount on travel voucher. B. Attach a Completed Travel Voucher Your department chair MUST sign the voucher as the authorizing signature C. Attach Documentation for Reimbursement Amounts Proof of conference & conference dates (e.g. print out of schedule or webpage of conference) Proof of registration Proof of payment (e.g. copies of credit card receipts, processed checks, banks statements) Please black out all sensitive information a map to verify mileage distance (if claiming mileage for a personal vehicle) additional receipts, if needed D. Signatures Applicant Signature Date Department Chair Signature Date Committee Approval: Approved Denied Committee Chair Signature Date updated 10/3/2018 Page 3 of 7

E. Additional Questions (your responses to these must be typed) (Please be detailed in your answers) 1. Describe your professional development goals below. 2. Explain below how the event for which you are asking reimbursement is related to your goals. 3. Explain below how you will integrate the knowledge gained from this event into your teaching at CCC. How will this help your students? Approximately HOW many students will this knowledge directly impact (guess)? Name _ PDF Event and Location/ or other updated 10/3/2018 Page 4 of 7

updated 10/3/2018 Page 5 of 7

Checklist When you have completed your application please check off that you have included the following items. If an item is not applicable to your application, use NA instead of a check mark. Turn this check list in with your application. Personal Information All information is included and is legible I have provided documentation of the dates my event took place. Part A General Budget Outline Registration Fee I have included documentation of my payment as well as documentation of the cost of the event. I have entered this fee in the appropriate area of the travel voucher. Travel Cost I have provided receipts for my airfare, train or bus cost. I have provided documentation of the need of a rental car, cost of car rental and my payment for the rental. I have included mileage documentation for use of a private vehicle. Lodging I have provided documentation of the cost of my lodging and printed out the allowed reimbursement chart from http://www.gsa.gov/perdiem for the area in which the lodging was located. Meals I have referred to the Meal Flowchart to determine what I can be reimbursed for. I have included receipts, if required. updated 10/3/2018 Page 6 of 7

Other I have provided documentation of both costs and my payment for anything not covered in the above categories. Part B Attach a Completed Travel Voucher Yes, I have included a travel voucher. Yes, I understand the travel voucher is actually a voucher for ALL expenses. Part C Attach Documentation for Reimbursement Amounts I have included the necessary receipts and made sure it is clear which receipt goes with which expense. I have eliminated any sensitive financial or personal information from my receipts. Part D Signatures My chairperson and I have both signed the PDF application. My chairperson and I have both signed the travel voucher with my chairperson both printing and signing their name. Part E Additional Questions I have typed and included my responses to the additional questions. updated 10/3/2018 Page 7 of 7