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DoubleTree Hotel, 1150 9th Street, Modesto Moving
from Confusion to Confidence: Using Outcomes Data to
Improve Local Programs, Facilitated
by W. Norton Grubb & Dr. Norena Badway
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College: |
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Address: |
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City/State/ZIP: |
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Name of
Person Completing Form: |
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Title: |
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Telephone
Number: |
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Workshop
your college will attend:
(circle) |
January
27-28, 2005 at The Pines Resort at Bass Lake February
3-4, 2005 at the DoubleTree Hotel in Modesto |
COLLEGE TEAM
MEMBERS (Please
PRINT.)
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Name of
CIO: |
CIO’s
Email Address: |
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Name of
Occupational Education Dean: |
Occupational
Education Dean’s Email Address: |
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Name of
Institutional Researcher: |
Institutional
Researcher’s Email Address: |
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Name of
Academic Senate Rep: |
Academic
Senate Rep’s Email Address: |
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Name of
Faculty Member: |
Email
Address: |
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Name of
Faculty Member: |
Email
Address: |
COMPLETE a FACULTY STIPEND AGREEMENT FORM for FACULTY each faculty member who will provide campus workshop.
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Agreement
Number: 04-342-001 |
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District: |
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College: |
In exchange for a $500 stipend, I agree to the
following stipulations as required by the grant funding:
Faculty:
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Printed Name |
Discipline Area |
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Signature |
Date |
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Instructional
Administrator:
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Printed Name |
Discipline Area |
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Signature |
Date |
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Vocational
Administrator:
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Printed Name |
Discipline Area |
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Signature |
Date |
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QUESTIONS
– CONTACT:
Sue
Clark
Coordinator
Central
Region Consortium
C/O
Columbia College
11600
Columbia College Drive
Sonora,
CA 95370
Telephone:
209.575.6915
Fax:
209.575.6587
Email: clarks@yosemite.cc.ca.us