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College Credit for Professional Development Submission Form

Name:

Department:

Phone Number:

Course Title:

Number of Hours Participated in Class:
(for example if the class met 2 hours a week for 10 weeks then the employee should have 20 hours of participation)

Start and End Date of College Course:

Professional Development Category:

Communication
Critical Thinking
Diversity
Interpersonal
Leadership
Personal
Teaching
Technology
Information Management
Budget

Was this course part of your Leaning Plan?

Yes
No

*You must submit documentation showing successful completion of the course with a final grade and institution name (or certification or completion etc if not a graded course) by sending interoffice mail or emailing pdf's of the final grade to staffdevelopment@grcc.edu