Staff Development Request Form
Committee Response:
Budget Maximum Approved
Submit
Date Submitted
-
Month
-
Day
Year
Date
Staff Member Name:
First Name
Last Name
Staff Member Email:
example@example.com
Staff Development Activity:
*
Department
*
Please Select
Elementary
Secondary
District-Wide
Administration
Athletics
Work Location
*
Please Select
Elementary
Secondary
Date(s) of Activity
*
Location of Activity
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Description of Activity.
*
Please list goals and objectives
Names of additional participants. (If applicable)
Select Expenses that apply:
*
Registration Fees
Lodging
Food
Substitute Cost
Mileage
Other Transportation Costs
Registration Expense Detail
Number of Attendees
Amount Per Person
Total Cost
Registration Cost
Upload Registration form or copy of online registration:
Browse Files
Cancel
of
How is payment being made:
Personal Card (once approved I will submit for reimbursement)
Administrator Credit Card
Please mail payment
Make Check payable to:
*
Mail payment to:
*
Lodging Expense Detail
Number of Rooms
Number of Nights
Amount Per Room per Night
Total Cost
Lodging Cost
Meal Expense Detail
Number of Attendees
Number of Days
Total Cost (max $25/day per attendee)
Meal Cost
Mileage Expenses
Applicant has confirmed a school vehicle is available
School vehicle is not available and personal vehicle will be used
School vehicle is available, but I will drive my personal vehicle
Transportation Expense Detail - Mileage paid at current IRS rate
Number of Miles
Total Cost (.67/mile)
Mileage Cost
Transportation Expense Detail - Mileage paid at school rate
Number of Miles
Total Cost (.30/mile)
Mileage Cost
Other Transportation Expense
Total Cost
Parking
Airfare
Other
Total Other Transportation Expenses
Substitute Expense
I will require a Teacher Substitute
I will require a Para Substitute
Teacher Substitute Expense Detail
Number of Days
Total Cost ($199.16/day)
Substitute Cost
Para Substitute Expense Detail
Number of Days
Total Cost ($145.18/day)
Substitute Cost
Grand Total Expenses
Submit
Should be Empty: