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Professional Development Grant Application

Part 1: Information

This application is for professional development opportunities for individual library staff. Each individual should submit a separate application, even if multiple staff people attend the same event. Each recipient is responsible for completing the required reports. For group trainings, please use the group training application. Please note that this form cannot be saved and we will not respond to incomplete applications.
Attendee Information
Attendee name(Required.)
Attendee email(Required.)
Attendee job title(Required.)
Library(Required.)
Event Information
What professional development event would you like to attend?(Required.)
Event dates(Required.)
Web address of the event
Estimated registration fee
Event format
Event location (city, state)
Estimated travel costs (including airfare, mileage, ground transportation, etc.)
Estimated lodging costs
Estimated other costs associated with this event
Please select the Washington State Library (WSL) goal and Library Services and Technology Act (LSTA) priorities supported by attendance at this event:(Required.)
How will participation in this event address the WSL goal and LSTA priorities selected? For a conference, please include examples of the programs and their potential impact on library services. (Required.)
How does this event relate specifically to the work you do in the library?(Required.)
How will your patrons benefit from your attendance?(Required.)
District/Organization/System name(Required.)
Mailing address(Required.)
City, ST and zip(Required.)
Statewide Vendor Number (eg. SWV0000000-00)(Required.)
UEI (Unique Entity ID: A 12-character alphanumeric string issued by sam.gov)(Required.)
Tax ID Number(Required.)
Washington State Legislative District
Federal Legislative District
Contracting Authority 
(The Contracting Authority is the person in your organization who is authorized to accept federal funding. Please check with your director or business office.)

Name(Required.)
Title(Required.)
Email(Required.)
Telephone(Required.)
Certification
Please indicate your understanding and conformance with the following statements. ALL FOUR MUST BE CHECKED OR YOUR APPLICATION CANNOT BE PROCESSED.(Required.)
This certification is now required on all applications, claims, and reports for federally funded grants. Please check the box to indicate your understanding and agreement.

I certify to the best of my knowledge and belief that the information provided herein is true, complete, and accurate. I am aware that the provision of false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil, or administrative consequences including, but not limited to violations of U.S. Code Title 18, Sections 2, 1001, 1343, and Title 31, Sections 3729-3730 and 3801-3812.
Thank you! WSL staff will review your application and contact you with any questions, then send you and the contracting authority an official award letter.
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