Innovation Scholarship Application Form

The Foundation for the Academic Senate for California Community Colleges (ASFCCC) is proud to offer scholarships to professional development opportunities for faculty to help expand their understanding of best practices, apply them at their local colleges, and share those results with the field and college. Special consideration will be given to applications that enhance and support Diversity, Equity, Inclusion, and Anti-racism.

Any faculty (full- and part- time faculty) from all disciplines are encouraged to apply. The scholarship awarded to the selected faculty will cover the cost of registration up to $1500. Eligible conference or event include workshops, classes, webinars, institutes, and conferences that are organized by a recognized and reputable organization.

In order for applications to be processed in time, applicants must submit their scholarship application no less than 8 weeks prior to the start of the conference/event. Applications are accepted on a rolling basis up to April 30th each year, and applicants will be notified 4 weeks prior to the start of the conference/event whether they will receive funding to attend. The number of scholarships awarded per academic year are subject to availability of funds for the ASFCCC. An application for the scholarship does not guarantee awarding of the funds.

Please direct any questions to Krystinne Mica, executive director. Krystinne@asccc.org

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Name *

First

Last

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 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 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 Hills College CoalingaWest Hills College LemooreWest Los Angeles CollegeWest Valley CollegeWoodland Community CollegeYuba CollegeOther

Other College not listed

Email *

Discipline *

Phone *

1. What is the name of the event or professional development activity you are applying for and what is the focus of the event? Please provide a link to the event/conference page.

2. How does the conference/event align with the work of diversity, equity, and inclusion and support faculty who are addressing these opportunity gaps for historically marginalized populations?

3. What are you hoping to gain from attending the conference/event and how will you apply that to your current work at your college?

4. How will what you learn at the conference/event align and support the Mission and Purpose* of the ASFCCC?

* https://asfccc.com/about-us/

5. Please provide a breakdown of the cost of attendance to the conference. Provide information on the registration fee, as well as any other associated fees to attend.

5. Please provide a breakdown of the cost of attendance to the conference. Provide information on the registration fee, as well as any other associated fees to attend. (copy)

6. Are you willing to present the information you’ve learned from the conference/event at a future Academic Senate for California Community Colleges event?

7. How did you hear about this scholarship opportunity?

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 and also to effectively and thoughtfully match mentors with mentees. 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/Black
• American Indian/Alaskan Native
• Asian/Asian American
• Caucasian/White
• Latino/a/x/Chicano/a/x
• Middle Eastern
• Native American/First Nations
• Pacific Islander
• Decline to state
• Other

Other racial/ethnic group

9. What is your sexual orientation? (check all that apply)

• Asexual
• Bisexual, pansexual or fluid
• Gay or lesbian
• Heterosexual or straight
• Queer
• Decline to state
• Other

Other sexual orientation

10. What is your current gender identity? (check all that apply)

• * Cisgender man
• * Cisgender woman
• ** Gender non-conforming
• **Genderqueer/non-binary
• ***Trans man
• ***Trans woman
• Decline to state
• Other

*(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 identity

Foundation Innovation Scholarship recipients will work with the foundation to pay for the identified professional development.

Signature *

• I hereby declare that the information provided is true and correct.

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