CTC Faculty Development Form- FE-1

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Record of Professional Development/Trip Report (Form FE-1)

Instructions:

Upon completion of activity, complete this form and click “Click to send as Email” Form automatically is sent to Training Coordinator. You may send a copy to yourself by entering your email address in the EMAIL** (last) field.
You may consolidate related activities on one Form FE-1.

Today's Date:

First Name:

Last Name:

PEID:

Department Name:

Email Address:

Faculty Status:

Faculty Location:

Activity Name:

Sponsored By:

Total Hours:

Activity Dates:

PD Category:
(choose only 1 category per FE-1 form)

Campus Requirements

Reimbursed Cost:

Instructional Areas

PIC
(Professional Organizations Institutional Involvement Community Involvement)

**Examples**
Campus Requirements (2 hrs*) EEOC Training Fall Preservice New Employee/QEP Training Graduation Department Meetings	Instructional Areas (6 hrs*) Content Area Conf./Workshops Technology Training Methodologies/Instructional Tng	PIC (6 hrs*) CTC Committee Work Faculty Senate TCCTA Prof. Organizations Community Organizations
*Full-Time Faculty Only

Please answer the following, as applicable:

Enter addtional email addresses to whom you want to send this form. Separate each email address by a semi-colon (;)

EMAIL**

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