Document Sample
					                                          CAREER DEVELOPMENT PLAN (CDP)
                                                   COVER SHEET
                                                             Please print neatly or type.
                                                                                                        Is this CDP:  New or
Name:                                                                                                                       Amended
                   (Last Name, First Name, Middle Initial)
                                                                                                        Date Entered
Social Security Number:                                                                                 State Service:

Unit Code:
Please check appropriate boxes:
   CLASSIFICATION YOU ARE WORKING TOWARDS                                                   DEGREE                              MAJOR OR
   Accountant                                                        Bachelor’s
   Agency Budget Specialist                                          Bachelor’s
   Agency Procurement Specialist                                     Bachelor’s
   Child & Adolescent Mental Health Associate, I-III                 Associate’s       Bachelor’s
   Community Health Educator, I-III                                  Bachelor’s        Masters
   Computer Network Specialist                                       Bachelor’s
   Data Base Specialist                                              Bachelor’s
   Epidemiologist, I-II                                              MPH               Masters
   Fiscal Services Administrator                                     Bachelor’s
   Fiscal Services Officer                                           Bachelor’s
   Fiscal Services Chief                                             Bachelor’s
   Internal Auditor                                                  Bachelor’s
   Laboratory Technician, I-II                                       Associate’s
   Nursing (all classifications & levels)                            Associate’s    Bachelor’s  Master’s  LPN
   Nutritionist, I-II                                                Bachelor’s     Master’s
   Occupational Therapy (all classifications & levels)               Associate’s    Bachelor’s  Master’s
   Personnel Officer I                                               Bachelor’s
   Pharmacist, I-III                                                 Bachelor’s     Master’s    Doctorate
   Physical Therapy (all classifications & levels)                   Associate’s    Bachelor’s  Master’s
   Psychology Associate  Psychologist                               Master’s       Doctorate
   Public Health Lab Scientist, I-II                                 Bachelor’s     Master’s
   Respiratory Therapist, I-III                                      Associate’s
   Sanitatrian, I-III                                                Bachelor’s
   Social Worker, I-II                                               Master’s
   Speech Pathologist/Audiologist, I-II                              Master’s
   Therapeutic Recreator                                             Bachelor’s         Master’s
   Other:                                                            Associate’s    Bachelor’s  Master’s  Doctorate

College or Institution Name:                                                                     Start Date:

Required Attachments:
              Letter of acceptance into program
              Listing of courses required for graduation (developed with your academic advisor)
              Letter of recommendation from supervisor

I understand that my Career Development Plan (CDP) will not be approved or used to qualify me for Tuition
Reimbursement unless it contains the documents listed above and is for one of the approved job classifications of
the current guidelines for Out-Service Training.

                   Employee Signature                                                                           Date

                   Appointing Authority/Designee                                                                Date

                   OST Coordinator                                                                              Date
         Return Completed Form to: Training Services Division, 201 W. Preston Street, Baltimore, MD 21201

Name: Enter your name, Last Name first then you First Name

Is this CDP: Please check () the appropriate response, if this is a new Career Development Plan or one that is
changed or amended.

Unit Code: Please write the administration/ facility/unit code that you will find below.

Classification You Are Working Towards: Please check () the box that is next to the classification you are
training/working towards.

Degree: Please check () the box that is next to the degree to which is sought.

Major or Concentration: Please enter the degree major (example, Chemistry)

College or Institution Name: Please enter the name of the college or university you are taking classes from.

Start Date: Please enter the date you are starting your educational coursework.

Employee Signature: Please sign the form.

Date: The date you, the employee, signed the form.

Appointing Authority/Designee: The administration’s/facility’s/local health department’s/unit’s Out-Service
Training Coordinator’s signature.

Date: The date the appointing authority/designee signed the form.

                                                               Unit Codes

 Code                      Title                   Code                     Title                   Code                     Title
AIDS    AIDS Administration                       FSA     Fiscal Services Administration           PGHD    Prince George's County Health
ADAA    Alcohol & Drug Abuse Administration       FCHD    Frederick County Health Department               Department
ACHD    Allegany County Health Department         GCHD    Garrett County Health Department         PR      Public Relations
AAHD    Anne Arundel County Health                GSA     General Services Administration          QAHD    Queen Anne's County Health
        Department                                GOVA    Government Affairs                               Department
BAHD    Baltimore City Health Department          HAHD    Harford County Health Department         RICB    RICA - Baltimore
BCHD    Baltimore County Health Department        HCAH    Health Care Access Cost                  RICR    RICA - Rockville
BON     Board of Nursing                                  Commission/Health Services Cost          RICS    RICA - Southern Maryland
BAC     Boards & Commissions                              Commission                               RHC     Rosewood Hospital Center
BMO     Budget Management Office                  HCF     Health Care Financing                    SCHD    Somerset County Health Department
CALH    Calvert County Health Department          HCS     Health Care Services                     SGHC    Spring Grove Hospital Center
CARH    Caroline County Health Department         HCAC    Health Choice & Acute Care               SHC     Springfield Hospital Center
CRRH    Carroll County Health Department          HRPC    Health Resources Planning Commission     SMHD    St. Mary's County Health Department
CEHD    Cecil County Health Department            HSAE    Health Services Analysis & Evaluation    TCHD    Talbot County Health Department
CHHD    Charles County Health Department          HSCR    Health Services Cost Review              TBFC    Thomas B. Finan Center
CPHC    Clifton T. Perkins Hospital Center                Commission                               USCH    Upper Shore Community Hospital
CPHA    Community & Public Health                 HCTR    Holly Center                             VITS    Vital Statistics
        Administration                            HOHD    Howard County Health Department          VOLS    Volunteer Services
COMR    Community Relations                       IRMA    Information Resources Management         WPCC    Walter P. Carter Center
CHC     Crownsville Hospital Center                       Administration                           WAHD    Washington County Health Department
DHC     Deer's Head Center                        JDBC    Joseph D. Brandenburg Center             WMC     Western Maryland Center
DPTR    Departmental Regulations                  KCHD    Kent County Health Department            WICP    WIC Program
DSPF    Deputy Secretary For Policy, Finance, &   LABS    Laboratories Administration              WIHD    Wicomico County Health Department
        Regulation                                                                                 WOHD    Worcester County Health Department
DPPH    Deputy Secretary For Public Health        MCFA    MCFC - Access, Quality & Programming
DSOP    Deputy Secretary Of Operations            MCFP    MCFC - Division of Program Services &
DDA     Developmental Disabilities                MCFQ    MCFC - Division of Quality Assurance
        Administration                            MCFR    MCFC - Division of Recipient Services
DDAC    Developmental Disabilities                MCFC    Medical Care Finance & Compliance
        Administration Central                            Administration
DDAE    Developmental Disabilities                MCOA    Medical Care Operations Administration
        Administration Eastern                    MHA     Mental Hygiene Administration
DDAS    Developmental Disabilities                MCHD    Montgomery County Health Department
        Administration Southern                   OHCQ    Office Of Health Care Quality
DDAW    Developmental Disabilities                OCME    Office Of The Chief Medical Examiner
        Administration Western                    SOS     Office Of The Secretary
DCHD    Dorchester County Health Department       PSA     Personnel Services Administration
ESHC    Eastern Shore Hospital Center             PQA     Physician Quality Assurance
EDC     Epidemiology & Disease Control            PCTR    Potomac Center
EXNM    Executive Nominations