Staff Development Grant Application Please read the Policy & Procedure page before applying

Your name: Address: City:    State:      Zip:   Phone:   Fax:   E-mail:     Position title: Employer: Work phone           List names and contact information for other cooperating libraries: Give a brief overview of the proposed training project: Provide detailed information on proposed training: Planning process/needs assessment: Topics of training: Presenters: Locations and dates: Outline of training program including times, method of delivery: Desired learning outcome(s) for participants: Anticipated impact on patrons: Target participants: numbers, limits, registration fees: Publicizing training:     Projected expenses: Give details for all amounts over $100. Expense category Estimated total cost Amount requested Speaker/presenter fee $ $ Speaker/presenter expenses $ $ Personnel costs $ $ Facility rental $ $ Equipment rental $ $ Equipment purchase $ $ Refreshments $ $ Supplies $ $ Printing $ $ Attendees expenses $ $ Substitutes $ $ Other $ $ Other $ $ Other $ $ TOTAL $ $         Date submitting application: Please type your name in the box below to serve as your virtual signature: