SAN JUAN COLLEGE
Fast Forward Program
Faculty/Staff Activity Request
The mission of the San Juan College Fast Forward Program is to build infrastructure and services that empowers
Native American students to complete AA/AS degrees and successfully transfer to four-year institutions.
*** Please submit this form no less than 45 days in advance of the activity. ***
Download and complete application in Adobe Reader. Submit application with "Email Form" button below.
Legal Name:
Current Date
02/17/2016
Datatel #:
(As it appears on driver’s license or government-issued identification)
Date Of Birth: 01/01/1990
Position:
School/Department:
Name of Activity/Conference:
My supervisor,
,is aware of and approves my participation in this activity.
SJC Approved Driver?
Yes
No
If No, please see the Fast Forward Administrative Assistant
Description of Proposed Activity/Conference:
Yes
No
Sponsoring Organization:
Activity/Conference Website:
Dates of Activity/Conference: 01/01/2016
________  01/02/2016
________
Location:
Title of Presentation: (if making a presentation)
Activity/Conference Fees:
Additional Fees (Pre/Post Sessions, Membership, etc.):
If approved, grant staff will determine all other travel arrangements (air, mileage, shuttle/taxi, hotel, meals, etc.).
Please select at least one (or more) of the grant goal(s) that will be further developed by your participation in this
activity and describe how the activity will enhance your professional skills and be incorporated into your position.
1. Improve Degree Completion for
Native American AA/AS Students
2. Improve Transfer Rates for Native
American Students (transfer
agreements, advising & counseling)
3. Improve Course Success Rates in Key
AA/AS Disciplines (English, Business,
Mathematics and Science)
Fast Forward Faculty/Staff Activity Request Form, Version 2.1, 2/17/16
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Have you ever participated in any previous Fast Forward sponsored activities?
If yes, what activities and when?
Yes
No
If you are interested in attending a Pre or Post Session, please list the name of the session and explain how this additional
session(s) will benefit your position and the goals of the grant.
Agreement and Acknowledgement of Travel Requirements
I understand that:
1.
2.
3.
4.
5.
6.
7.
Approval of this travel request is dependent upon funding and applicability to grant goals and objectives;
If my travel request is approved, I am required to submit a travel report within two weeks of my return;
I must sign the Fast Forward Traveler’s Agreement before departing on travel;
I will adhere to the SJC Travel Protocol guidelines;
I need to submit my date of birth and my name as it appears on my Driver’s License for airline travel;
I may be asked to share information that I acquired at a Fast Forward sponsored activity;
Notwithstanding unforeseen extenuating circumstances, I will provide a two week cancellation notice;
otherwise, my department may be responsible for all associated travel costs.
I agree with the above statements
I do not agree with the above statements
Thank you for your submission. Please allow one week for a response from the Fast Forward
Program. Instead of printing this form, click the "Email Form" button to the right to email the form.
Email Form
Note: Clicking "Email Form" should open your email client (Outlook, Apple Mail...). There you can
see this PDF attachment, email Subject, and Brenda's email address. Otherwise, please print this
form and drop if off with Brenda Bennie at the Transfer Center in room 1307.
The Fast Forward Program is funded through a U.S. Department of Education Title III Native
American Title III Native American Serving Non-Tribal Institution grant, 2011-2016.
Fast Forward Program Use Only
Date Received:
Approved:
Reason for Disapproval:
Date Reviewed:
Disapproved:
Fast Forward Faculty/Staff Activity Request Form, Version 2.1, 2/17/16
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