Remedy Pre-Approval Form

Your Name*

Last NameFirst Name

Email*

example@example.com

Mailing Address*

Street Address

Street Address Line 2

CityProvince

Postal Code

Worksite/School*

Teaching Assignment*

Choose the option that best suits your pre-approval request:*

Resources/SuppliesProfessional Development

Please provide details of the professional development activity:*

Date(s) of activity: Date to Date

Explain in detail how this professional development will impact your teaching and DIRECTLY benefit your students.*

Is a Teacher Teaching on call required?

YesNo

Date(s) required: Date to Date
Full Day AM PM N/A

Explain in detail how these resources will DIRECTLY benefit your students.*

Estimated Resource Costs:

	Vendor (if known)	Detail	Estimated Cost (CAD) $
1
2
3
4
5
6
7
8
9
10

Estimated Professional Development Costs:

	Vendor (if known)	Detail	Estimated Cost (CAD) $
Airfare
Ferry
Taxi, Parking, etc
Hotel
Mileage (0.68/km)
Breakfasts ($20 each)
Lunches ($25 each)
Dinners ($40 each)
Supplies
Program Fees/Tuition

Pre-Approval Total

Submission Date*

Date

Signature*

Clear

*By signing this form, you are confirming that the intended use of the funds being requested is 100% for teaching purposes. (Unsigned forms will be denied.)

-- You will be notified by email if this request has been approved --

CVTU reference #: