ࡱ>  }bjbj hhTXX8dK,g<( +++++++$-P0t+uo!o!o!+4p,s's's'o!X+s'o!+s's')A*;A#! *+,0,*,0"L0A*0A*o!o!s'o!o!o!o!o!++%o!o!o!,o!o!o!o!0o!o!o!o!o!o!o!o!o!X a: Name: FORMTEXT      Position: FORMTEXT      Dept/School: FORMTEXT       Regular Faculty Employee, Step  FORMTEXT      Regular Technical Staff Employee, Step  FORMTEXT      Regular Assistant Instructor Employee, Step  FORMTEXT      Other (define):  FORMTEXT      , Step  FORMTEXT      Date I became a regular employee:  FORMTEXT       Most recent 10.5 Leave:  FORMTEXT       months at  FORMTEXT      % taken between  FORMTEXT       and  FORMTEXT      N/A  FORMCHECKBOX Most recent 10.5  Tuition : $ FORMTEXT       received on  FORMTEXT      N/A  FORMCHECKBOX  General Intent of Article 10.5 10.5.1.1. to maintain the currency, flexibility and professional competence of Employees, and 10.5.1.2 to augment the professional development of the individual Employee.Leave Activity Proposed by this application: (attach additional information as required per Article 10.5.3.7) FORMTEXT      Funding is requested for:Leave (twelve month maximum) from:  FORMTEXT       to  FORMTEXT      , to be taken: FORMCHECKBOX  as a single block of time FORMCHECKBOX   FORMTEXT       weeks during the period defined above FORMCHECKBOX   FORMTEXT       days during the period defined above FORMCHECKBOX   FORMTEXT       hours during the period defined aboveand/or $ FORMTEXT       in total to pay for tuition/conference fees and/or costs related to the activity, broken down by: - tuition/conference fees in the amount of $ FORMTEXT       - accommodation/meals in the amount of $ FORMTEXT       - travel costs in the amount of $ FORMTEXT       - other related expenses in the amount of $ FORMTEXT        General Criteria and Requirements: A. Attached is a statement from my Department (Associate Dean/Manager and Colleagues) indicating their endorsement of the PD activity I am proposing. (initials) __________ Reference: Article 10.5.3.5 B. I understand that by accepting the paid leave described above, that upon the conclusion of the leave, I accept the obligation to undertake a subsequent period of employment equal in time to the period of the paid leave. (initials) __________ Reference: Article 10.5.3.6 C. Attached is a statement of the proposed program of studies, and my perceptions of the relevance of this planned activity to my present or possible future role in the Institutes activities or to the Institutes concerns.  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If applicable, attached is documentation of acceptance into the proposed program of studies or work experience activity. (initials) __________ Reference: Article 10.5.3.8 E. I will inform the Committee of any significant change in the circumstances of my leave activity. (initials) __________ Reference: Article 10.5.3.11 F. I will submit a report of my leave activity, including the amount of any income stemming directly from it, to my Department and the Professional Development Leave Committee within one (1) month of the expiry of my leave. (initials) __________ Reference: Article 10.5.3.12  FORMTEXT      Signature of EmployeeDate Submitted Date Received Departmental Approval (10.5.3.5) This is to advise that I ( FORMTEXT      ) am applying for PD leave and/or funding of  FORMTEXT       to participate in the following professional development activity:  FORMTEXT      Please sign below to indicate your support for this PD activity: NameTitleSignature FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT           Application for Professional Development FSA/BCIT Collective Agreement Article 10.5 (Rev: September 2008)Page  PAGE 3 of  NUMPAGES 3 &q^q`qdqqqqqqqqqqqqqqqr0rDzǝsaaٝO="hCJOJQJ^JaJmH sH 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