Form 1000 Professional Development (P.D.) Request

Form 1000 Professional Development Request Form

Only complete this form for pre-approval of P.D.
The form shall be submitted no later than two (2) weeks prior to the requested professional development (P.D.), prior to the commencement of a class, and no later than six (6) weeks in advance for P.D. requiring travel. Information regarding the P.D. fund is available at:

RCSTA - Professional Development
Name

First NameLast Name
Email (Must be RCSD Email)
example@rcsd.ca
Employee # (5-digit # found on RCSD Earnings Statement)
example 12345
Administrator Email (Must be RCSD Email)
example@rcsd.ca
Years Taught with RCSD:
What type of contract are you on?
Name or Title of Professional Development or Course Number and Institution
P.D. Location

Street Address

Street Address Line 2

CityProvince

Zip CodeCountry
If the P.D. is not in Regina, have you considered any local or distance options?
Have you attended this P.D. before?
Starting Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Ending Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Describe the nature of the P.D. or upload the published description below.
Upload Published Conference or Course Description - If Available

Cancelof
Describe your goals/expected outcomes for participating in this P.D.
Describe the potential impact attending this P.D. will have on student achievement in your classroom.
Professional Development Funds Requested
Expenses are reimbursed according to predetermined allowance amounts, set by the school division as maximums eligible for coverage. Any costs exceeding the allowance are the responsibility of the applicant.

Estimated Expenses (if applicable)

Rows	Estimated Expense
Registration/ Tuition
Accommodation (max $140.00/night incl. taxes and fees)
Meals ($16.00, $23.00, $31.00) - Do not claim if meal is provided
Travel (Current mileage rate is $.61/km)
Teacher Substitute ($390.78/day)
Other (please specify)

Other Expense Request Explanation (if applicable):
Total Requested Expense
Total Requested Expense
Max $2400.00/3 years
Approved Up To:
RCSTA Office Use Only
Incomplete forms may delay the application approval flow or result in the denial of a request. All PD applications will require substitute billing equivalents for PD occurring on student contact days per the RCSD school calendar except where LINC days are applied.
Incomplete forms may delay the application approval flow or result in the denial of a request. All PD applications will require substitute billing equivalents for PD occurring on student contact days per the RCSD school calendar except where LINC days are applied.
Should be Empty:

Form 1000 Professional Development Request Form