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					         APPLICATION FOR MANSFIELD CAMPUS PROFESSIONAL
                       DEVELOPMENT GRANT

Professional Development Grants may be for small, large, or group projects. The
maximum award is $1,000 per year per individual. Individuals may pool their awards for
a group project. Please submit seven (7) typewritten copies and one copy of your CV to
the chairperson of the Professional Development Committee. Complete all blanks; be
brief, yet complete, and use language understandable to one not necessarily expert in
your field. Additional information the applicant considers necessary may be attached to
this form.

There are two deadlines per year for submitting grants:
   May 1 — for projects to be conducted at any time during the next fiscal year (July 1
       to June 30)
   November 15 — for projects to be conducted between January 1 and June 30 of the
       current fiscal year

Awards will be announced no later than one month prior to the start of the grant period.
The committee may consult your department chair or other individuals about the merits
of your proposal.



Name: ___________________________ Academic Rank: ____________________

Department: ______________________ Chairperson: _______________________

Title of project: ________________________________________________________

Grant period: _____________________ Application date: ____________________

If the work will be done somewhere other than the Mansfield Campus, please indicate
locations:




Which category of professional development is this grant meant assist? Please check one
of the following and explain in more detail as requested below (if the grant can assist you
in more than one area, please indicate the one that the grant will help the most):

____ research                 ____ teaching                  ____ service
State your professional development objectives in applying for this grant.




Describe your professional development plans for utilizing this grant.
Does this project involve human subjects? ______ Yes ______ No.

If “yes,” provide protocol number and date of the review by the Human Subjects
Committee.



Does this project involve animal subjects? ______ Yes ______ No.

If “yes,” describe steps taken or to be taken to obtain approval of the protocol.




List research support for the current and preceding three years and pending proposals:
For previous grants, summarize the outcomes or accomplishments.

Source                   Amount               Project period         Project title
Please provide an itemized budget.

       Personnel

               Salary for replacement faculty

              Wages for student assistant

               Other

                                                                 Subtotal          $



       Consumable materials (itemize)                            Subtotal          $




       Equipment (itemize)                                       Subtotal          $




       Travel (itemize transportation and subsistence separately) Subtotal         $




       Other expenses (itemize)                                  Subtotal          $




                                                          Total request            $




                                                                       Revised December 2007

				
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