Faculty Scholarship Application Form for the 2024 Colegas Annual Conference Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.The Academic Senate Foundation is proud to offer scholarships for faculty to attend the Colegas 2024 Annual Conference on November 5-6, 2024 at the SAFE Credit Union Convention Center in Sacramento. The scholarship will cover the cost of registration ($800), hotel accommodations ($400 total), and $300 in travel costs for select scholarship winners. Details about the deadline are at the bottom of this application form. If you are a selected winner of the scholarship, you will be notified by us at foundation@asccc.org and the scholarship award will be provided as a reimbursement after the conference date. Name *FirstLastEmail *College *Alameda, College ofAllan Hancock CollegeAmerican River CollegeAntelope Valley CollegeBakersfield CollegeBarstow CollegeBerkeley City CollegeButte CollegeCabrillo CollegeCalbright CollegeCanada CollegeCanyons, College of theCerritos CollegeCerro Coso CollegeChabot CollegeChaffey CollegeCitrus CollegeClovis Community CollegeCoalinga CollegeCoastline CollegeColumbia CollegeCompton CollegeContra Costa CCDContra Costa CollegeCopper Mountain CollegeCosumnes River CollegeCrafton Hills CollegeCuesta CollegeCuyamaca CollegeCypress CollegeDe Anza CollegeDesert, College of theDiablo Valley CollegeEast Los Angeles CollegeEl Camino CollegeEvergreen Valley CollegeFeather River CollegeFolsom Lake CollegeFoothill - De Anza CCDFoothill CollegeFresno City CollegeFullerton CollegeGavilan CollegeGlendale CollegeGolden West CollegeGrossmont CollegeHartnell CollegeImperial Valley CollegeIrvine Valley CollegeLake Tahoe Community CollegeLaney CollegeLas Positas CollegeLassen CollegeLemoore CollegeLong Beach City CollegeLos Angeles CCDLos Angeles City CollegeLos Angeles Harbor CollegeLos Angeles Mission CollegeLos Angeles Pierce CollegeLos Angeles Southwest CollegeLos Angeles Trade Technical CollegeLos Angeles Valley CollegeLos Medanos CollegeLos Rios CCDMadera Community CollegeMarin, College ofMendocino CollegeMerced CollegeMerritt CollegeMiraCosta CollegeMission CollegeModesto Junior CollegeMonterey Peninsula CollegeMoorpark CollegeMoreno Valley CollegeMt. San Antonio CollegeMt. San Jacinto CollegeNapa Valley CollegeNorco CollegeNorth Orange Continuing EducationOhlone CollegeOrange Coast CollegeOxnard CollegePalo Verde CollegePalomar CollegePasadena City CollegePeralta CCDPorterville CollegeRancho Santiago CCDRedwoods, College of theReedley CollegeRio Hondo CollegeRiverside CCDRiverside City CollegeSacramento City CollegeSaddleback CollegeSan Bernardino Valley CollegeSan Diego City CollegeSan Diego Continuing EducationSan Diego Mesa CollegeSan Diego Miramar CollegeSan Francisco, City College ofSan Joaquin Delta CollegeSan Jose - Evergreen CCDSan Jose City CollegeSan Mateo CCDSan Mateo, College ofSanta Ana CollegeSanta Barbara City CollegeSanta Monica CollegeSanta Rosa Junior CollegeSantiago Canyon CollegeSequoias, College of theShasta CollegeSierra CollegeSiskiyous, College of theSkyline CollegeSolano Community CollegeSouthwestern CollegeTaft CollegeVentura CollegeVictor Valley CollegeWest Los Angeles CollegeWest Valley CollegeWoodland Community CollegeYuba CollegeOtherAcademic Senate President Name *Cell Phone *Discipline *Other College not listedAcademic Senate President Email *Application Questions2. Have you previously received a scholarship from the Foundation for ASCCC during the academic year of 2023 or 2024? *YesNo4. What do you seek to gain as a result of attending the 2024 Colegas Conference? *5. How will what you gained during the conference help in your work with students? *6. How will what you gain help you advance as a faculty leader? *7. How could your involvement in this conference improve your local senate or local faculty leadership? *Optional Information The ASCCC aims to intentionally support the increase of development opportunities for diverse faculty, as called for in the ASCCC Strategic Plan 2018-2023 Goal 2 Objective 2.1. In order to design and lead professional development opportunities for diverse faculty, it is essential to begin gathering data to identify and meet the needs of the diverse faculty in our community college system. We ask that you please consider answering the following optional questions to help us identify the needs of our diverse faculty. Please know that we value your voice and confidentiality, and this information will be secure and not shared or published without permission. 8. With which racial/ethnic group(s) do you identify? (check all that apply) African American/BlackAmerican Indian/Alaskan NativeAsian/Asian AmericanCaucasian/WhiteLatino/a/x/Chicano/a/xMiddle EasternNative American/First NationsPacific IslanderDecline to stateOtherOther racial/ethnic group9. What is your sexual orientation? (check all that apply)AsexualBisexual, pansexual or fluidGay or lesbianHeterosexual or straightQueerDecline to stateOtherOther sexual orientation10. What is your current gender identity? (check all that apply)* Cisgender man* Cisgender woman**Gender non-conforming**Gender queer/non-binary***Trans man***Trans womanDecline to stateOther*(Cisgender is defined as a person whose gender identity aligns with their sex assigned at birth) **(Gender non-conforming is defined as a person whose behavior or appearance does not conform to traditional gender expectations) ***(Transgender is defined as a person whose gender identity and/or expression is different from their sex assigned at birth)Other gender identityThe deadline to submit is October 9, 2024 at 5:00 PM (PST). Selected faculty will be notified via email two week after the submission date. Signature *I hereby declare that the information provided is true and correct.Submit