Classified Professional DevelopmentMembership, Subscription, Certification Dues and Fees Funding

Classified Professional Development

Membership, Subscription, Certification Dues

and Fees Funding

This request form is for one time or recurring

professional fees only.

Can your department provide any funding?*

Fee Type*

membership

subscription

fellowship

license

L Number*

First and last name*

Email address*

Department*

Job Title*

FTE Status*

1.0

.50-.99

Less than .50

Have you completed your initial trial service?*

Yes

Not Sure

Name of the Organization*

Please spell out acronyms

Title of membership/fee*

Link*

Please provide a link to a webpage that provides details and cost.

Total amount of funds requested*

Please provide a cost breakdown if necessary

When will you request reimbursement?*

Updated Q&A Requirement

When responding to the Organization and Activity Description question please be brief and reply in your own words. It's important to respond to the bullet points.

When responding to the Relevance & Value question, it’s important to clearly explain how the professional development activity will benefit you and LCC in your current role.

Rather than a general statement about what the organization provides, please share specific examples or a brief explanation of its direct impact on your work and its benefit to LCC.

Organization Description*

In your own words, tell us about the benefit and what you intend to do as part of your participation.

• A brief description of the organization

• Specific information you plan to utilize

Relevance and Value*

Will this benefit you and LCC?

In your own words, tell us how this will benefit you and LCC in your current position. Please be explicit and thorough in your response.

Additonal information you would like us to know

Classified Professional Development Policy*

I have read and understand the Classified Professional Development Rules https://inside.lanecc.edu/cpdt/classified-professional-development-reimbursement-programs

College Online Policy and Procedure System (COPPS)*

https://inside.lanecc.edu/copps/documents/travel-or-expense-reimbursement

Employee Agreement *

For activities that occur during my normal working hours, I have made arrangements with my manager and they have authorized my attendance.

Send me a copy of my responses

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