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Human Resources at Broward Community College

Assistance Request Form

To request assistance from the Professional Development & Training Office in planning your event, please complete and submit the form below. Someone from the office of Professional Development & Training will follow-up with you within five working days.

 

Please note: Although we try to utilize BCC talent whenever possible, we often must enlist the services of outside contractors. As a result, a three to four month advance notice is required if you are requesting assistance in securing a speaker or facilitator for an event/workshop.

Today's Date:
Department:
*Contact Name:
*Contact's Phone:
*Contact's E-mail:

 

What services are you requesting from Professional Development & Training? Please complete all applicable sections before you submit the form.

  1. Professional development credit for an activity or event.
  2. Advertisement of activity or event.
  3. Room setup or paperwork/equipment for an activity or event.
  4. Speaker/facilitator for your department or campus.

 


Complete this section to request professional development credit for an activity/event:

How many hours of Professional Development are being requested?

 

Requesting credit for:
            

 

Name/title of activity:
Location:
Date/Time:

 

Supporting documentation:


       1) An agenda - list all presenters.   


       2) A brief description of the learning outcomes.


              

 

Note: We will provide sign in sheets and attendance records.

 


1) Name/title of activity:
2) Date:
3) Time:
4) Location:

 


 


 


 


 

(explain)

 

If not entered above (Requesting Professional Development Credit or Advertising), please provide the following information:

 

1) Name/title of activity:
2) Date:
3) Time:
4) Location:


       

Please specify any paperwork and/or equipment that you would like for your presentation/workshop by checking all of the appropriate boxes. Please let us know if we need to make special arrangements for equipment that you will be bringing with you.

 

Attendance Sheets
Workshop Evaluations
White Board/Chalk board (specify which)
Easel/Flip Chart (specify which)
Extra Tables
LCD Projector
Computer - PC (BCC does not provide Macintosh computers)
                          Software
                          Internet connection
                          MS program to be used (e.g. PowerPoint, Word)
Lecturnette
Microphone-Hand held/Lapel (specify which)
Overhead Projector
Screen
TV/VCR
Other (please specify)

 

 

What type of classroom facility/set up best suits your needs?


Classroom style
Lecture style (tiered/fixed seats)
U-Shaped (tables w/movable chairs)
Other (please specify or e-mail chart to ProfDevTrng@broward.edu)


We would like to have your permission to photograph your presentation for use in our newsletter.

Yes   No

 

If requested, we would like to have your permission to videotape your presentation.

Yes   No

 


Complete this section to request a workshop or speaker/facilitator for your department/campus:

What type of event/workshop are you planning?


If other, please specify


Topic   

 

Do you need Professional Development & Training to secure a speaker/presenter?



Do you have a preferred speaker/facilitator?
- Name and contact information


Will you or a member of your staff need time to present?
- How much time will you need?

 

Date Preference: Alternate Date:  
Time Preference: Length of Event:

 

 

Location Preference:


   If other, please specify

 

Estimated Number of Attendees:

 

Audience (select all that apply):



 

   If "Other", please specify 

Cancellation note: A two week notice is required to not affect the funding source.

This page was last modified on Fri, Jun 19, 2009
 
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