Professional Development & Hotel Assistance Application | Recharge 2020
In partnership with the Utah Department of Workforce Services, Office of Child Care, and the George S. and Dolores Dore' Eccles Foundation, the Utah Afterschool Network is providing Professional Development Assistance Award opportunities to out-of-school time professionals in Utah to help offset the registration cost for Southern Recharge in St. George and Northern Recharge in Salt Lake City. Hotel Assistance Awards are also available to assist with hotel accommodations for individuals attending either training, with priority given to organizations more than 90 miles from the venues.

Professional Development and Hotel Awards Timeline:
Open Date: November 8, 2019
Close Date: January 7, 2020 at 6:00 p.m.
Award Notification will be emailed by January 10, 2020

**Professional Development Assistance Awards**
- Professional Development Awards are available for registration for both Northern Recharge and Southern Recharge.
- One award is intended to cover a partial cost of one individual’s registration and cannot be shared among multiple individuals.
- If one award is received, the organization will register one individual for the training with a discount code valued at $20.
- Please wait to register individuals until you receive notification of the Professional Development Awards so you can use the discount code at the time of registration.
- The organization is responsible for the additional registration costs associated with the training.
- Organizations may apply for more than one award so multiple individuals may receive a discount.

**Hotel Assistance Awards**
- Hotel Assistance Awards are available for February 7, 2020 in St. George, UT and February 28, 2020 in Salt Lake City, UT for individuals attending the trainings.
- Priority will be given to organizations located more than 90 miles from the training venues.
- If an award is received, the organization will be responsible for reserving the hotel room and paying in full all room costs, taxes, fees, and other charges directly to the hotel. After the event, the organization will be reimbursed for hotel accommodations up to $75 per award. Remaining cost of hotel room, if any, will be the responsibility of the organization and will not be reimbursed.
- Hotel Awards are intended for double occupancy rooms.
- Organizations may apply for more than one hotel award.

**Professional Development and Hotel Award Terms and Conditions**
- Completing this form does not register or reserve space for individuals attending either Northern Recharge or Southern Recharge.
- Completing this form does not reserve hotel accommodations.
- Professional Development Awards will be awarded in the form of a discount code which will remove $20 at the time of registration. **Please wait to register individuals for the training until you receive notification of your request.**
- Hotel Assistance Awards will be reimbursed up to $75 per award after the conference.
- Organizations will not be reimbursed for Hotel Award(s) if missing required documentation, outlined in the notification email.
- In the event that an organization has a large award request, the number may be reduced.

Please contact Emilie or Amberley with any questions at professionallearning@utahafterschool.org.
**Only one application accepted per organization**
If multiple programs operate under one organization, please coordinate with all programs and submit only ONE APPLICATION for all Professional Development Awards and Hotel Assistance Awards the organization as a whole is requesting.
Organization Name *
Your answer
Organization Address *
Provide a complete address for the organization, including street, city and zip code.
Your answer
First and Last Name of Main Contact *
All correspondence regarding Awards will be sent to this individual.
Your answer
Email Address *
All correspondence regarding Awards will be sent to this email address.
Your answer
Phone Number *
Your answer
How many Southern Recharge registration awards is the organization requesting? *
This should include the total number of Professional Development Awards the organization as a whole is requesting to be used for Southern Recharge on February 8, 2020 in St. George.
Your answer
How many Northern Recharge registration awards is the organization requesting? *
This should include the total number of Professional Development Awards the organization as a whole is requesting to be used for Northern Recharge on February 29, 2020 in Salt Lake City.
Your answer
How many Southern Recharge hotel awards is the organization requesting? *
One "hotel award" is equal to one night in one room to be used on February 7, 2020 in St. George. If multiple individuals are in need of hotel accommodations, you would request more than one hotel award.
Your answer
How many Northern Recharge hotel awards is the organization requesting? *
One "hotel award" is equal to one night in one room to be used on February 29, 2020 in Salt Lake City. If multiple individuals are in need of hotel accommodations, you would request more than one hotel award.
Your answer
I have read and agree to the terms and conditions outlined above. *
DON'T FORGET TO SUBMIT!!
Submit
Never submit passwords through Google Forms.
This form was created inside of Utah Afterschool Network. Report Abuse