REQUEST FOR PROFESSIONAL LEAVE
EMPLOYEE INFORMATION
EMPLOYEE NAME
First Name
Last Name
Email
example@example.com
SCHOOL / LOCATION
Please Select
IES
LES
PCMS
PCHS
Special Education
IT Department
Maintenance
District Office
Select your primary location. NOT what department your traveling for.
ASSIGNMENT
Please Select
Administration
Certified
Classified
Other
MEETING/CONFERENCE INFORMATION
TITLE OF MEETING/CONFERENCE
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LOCATION OF MEETING/CONFERENCE
DATES OF MEETING/CONFERENCE
Including Travel Time
LEAVE DATE
-
Month
-
Day
Year
Date
RETURN DATE
-
Month
-
Day
Year
Date
CRITERIA FOR PROFESSIONAL LEAVE
REASON FOR LEAVE
Please Explain How the Professional Leave will be of Direct Value to PCSD
I UNDERSTAND THAT ATTENDANCE AT THE PROFESSIONAL ACTIVITY IS SUBJECT TO BEING ABLE TO OBTAIN ADEQUATE SUBSTITUTE EMPLOYEES, IF REQUIRED.
I UNDERSTAND
I UNDERSTAND THAT PROFESSIONAL LEAVE MAY NOT BE TAKEN DURING THE FIRST TWO OR LAST TWO WEEKS OF THE SCHOOL YEAR EXCEPT IN EXTENUATING CIRCUMSTANCES.
I UNDERSTAND
I UNDERSTAND THAT LEAVE MUST BE REQUESTED AND APPROVED BY SUPERVISOR AND SUPERINTENDENT AT LEAST SIXTY (60) DAYS PRIOR TO DATE OF MEETING/CONFERENCE.
I UNDERSTAND
I UNDERSTAND THAT ANY OUT-OF-STATE PROFESSIONAL LEAVE MUST BE APPROVED BY THE PCSD BOARD OF TRUSTEES PRIOR TO TRAVEL.
I UNDERSTAND
WILL YOU BE REPRESENTING PCSD AT A NATIONAL, REGIONAL, OR LOCAL CONFERENCE?
YES
NO
How will it result in the direct benefit to PCSD?
HAS EMPLOYEE’S PRESENCE BEEN REQUESTED BY GOVERNOR OF THE STATE OF NEVADA? OR THE NEVADA DEPT OF EDUCATION?
YES
NO
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IS ATTENDANCE AT THE PROFESSIONAL ACTIVITY LEGAL WITHIN THE APPLICABLE STATE LAWS?
YES
NO
DOES ATTENDANCE CONFLICT WITH POLICIES AND REGULATIONS OF PCSD?
YES
NO
WILL ATTENDANCE AT THE PROFESSIONAL ACTIVITY UNDULY INTERFERE WITH THE EMPLOYEE’S MAIN JOB RESPONSIBILITIES?
YES
NO
WILL THE INFORMATION GAINED FROM ATTENDANCE BE MADE AVAILABLE TO OTHER PCSD PERSONNEL?
YES
NO
WILL AN OUTSIDE ENTITY PAY THE COSTS OF (OR A PORTION OF) TRAVEL, PER DIEM, REGISTRATION, SUBSTITUTE TEACHER, AND OTHER EXPENSES?
YES
NO
Name of Entity, Contact Info
PROPOSED FUNDING SOURCE FOR PROFESSIONAL LEAVE & TRAVEL
COSTS SHOULD NOT EXCEED GSA AMOUNTS (www.gsa.gov)
PROPOSED SOURCE OF FUNDS
Please Select
GRANT
GENERAL FUND
SPECIAL EDUCATION
ASSOCIATED STUDENT
OTHER
NAME OF SPECIFIC GRANT/DEPARTMENT
FUNDING ACCOUNT NUMBER TO BE CHARGED
ESTIMATED REGISTRATION COST
ESTIMATED PER DIEM COST
ESTIMATED HOTEL COST
ESTIMATED FLIGHT COST
ESTIMATED TRANSPORTATION (RENTAL CAR/TAXI/UBER/PARKING)
OTHER INFORMATION
EXTRA INFORMATION
I understand that submitting this Request for Professional Leave & Travel does not constitute a request for leave through the PCSD Portal. Once leave and travel have been approved, I must enter a request for leave in the PCSD Portal. I also understand that once leave and travel have been approved, I will work with my supervisor to register for training and to book the required travel.All requests for reimbursement should be submitted within 5 business days after return from travel.
I UNDERSTAND
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