Form 1000 Professional Development Reimbursement Form
Only complete this form for pre-approved and completed P.D.
Name
*
First Name
Last Name
Email (Must be RCSD Email)
*
example@rcsd.ca
Employee # (5-digit found on RCSD Earnings Statement)
*
example 12345
Type a question
*
I completed a request and was approved.
I did not complete an approval or was not approved.
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Name or Title of Professional Development or Course Number and Institution
*
Starting Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Ending Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please provide a summary of the P.D. Learnings.
*
Would you recomend this P.D. to a colleague? Why or why not?
*
Please Upload Supporting Documents to Ensure Reimbursement
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of
I have uploaded:
Proof of completion and/or attendance
Proof of payment (tuition payment must include course number)
Accommodation receipt (if applicable)
Travel receipts (if applicable)
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Professional Development Funds Requested
Substitute Costs
*
Rows
Total Sub Cost
Substitute Cost - $390.78/Day
Actual Expenses
*
Rows
Actual Expense
Registration
Accommodation (max $140.00/night incl. taxes and fees)
Meals ($16.00, $23.00, $31.00)
Travel (Current mileage rate is $.57/km)
Other (please specify)
Total P.D Cost (Max, if approved is $2400.00) - Please note that substitute costs are deducted first.
Total Payable to Teacher:
Total Requested Reimbursement
*
Max $2400.00
Total Payable to Teacher
RCSTA Office Use Only
RCSTA USE ONLY
Total Payable to Teacher:
RCSTA Approval:
Date:
Budget Code:
Calculation
Submit
Should be Empty: