Staff Development Application
Date of request: ______________________ Phone: ____________________________
Name: __________________________________________
SSN:_________________ (Only for employees requesting to take classes.)
Employee Status:
_____full-time
_____ part-time
Purpose:______________________________________________________________
_______________________________________________________________________Please indicate whether the request is for a class, workshop, seminar, or conference and how it relates to your area of responsibility and will enhance your job performance. For additional information refer to the Institutional Policy on Classified Staff Development (Answer Book #IV-19)
Amount requested for :
Lodging ____________
Travel ____________
Registration ____________
Other ____________
For workshops, seminars or conferences, please attach general
information regarding the workshop, seminar or conference (i.e. brochure,
pamphlet or information from the internet).
Amount requested for:
Tuition ___________
Fees ___________
Books ___________
For WVUP tuition, fees and books, please submit Employee Scholarship Application to Financial Aid Office.
TOTAL COST _________
Print and complete form. Return completed form to Patsy Bee by the last day of the month.
WVU Parkersburg Staff Council encourages employees to donate money from the sale of their books back to the WVU at Parkersburg Foundation Employee Scholarship Fund to provide additional funds for staff in the future.
Financial Aid Office Use Only:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________