Request to Attend a Meeting Form (Certified)
Name of Employee:
*
Employee Email:
*
Employee Number:
*
School/Department:
*
Please Select
Burnside Elementary School
Central Office
Curriculum
Day Treatment/Eagle Academy
Eubank Elementary School
Finance
Food Services
Gifted & Talented
Memorial Education Center
Nancy Elementary School
Northern Elementary School
Northern Middle School
Oak Hill Elementary School
Pulaski County High School
Pulaski Elementary School
Shopville Elementary School
Southern Elementary School
Southern Middle School
Southwestern High School
Special Education
Student Services
Sunrise
Technology
Place of Meeting/Reason for Absence:
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Start Date of Meeting:
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/
Month
/
Day
Year
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End Date of Meeting:
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/
Month
/
Day
Year
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Exact Dates Absent from Work:
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Is this flexible professional development?
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Yes
No
If yes, number of hours?
Are you requesting professional development credit?
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Yes
No
If yes, has credit been approved by the professional development coordinator?
Yes
No
Will you be participating as a consultant?
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Yes
No
If yes, will you be paid for your services?
Yes
No
Request trip be approved as professional leave with no deduction?
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Yes
No
Request trip be approved with travel paid as estimated below?
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Yes
No
Substitute needed?
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Yes
No
If yes, number of days substitute needed?
List exact dates substitute will be needed:
Proposed means of travel (select all that apply):
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Personal Car
Bus
Airplane
Train
None
Other
Estimated expenses:
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Rows
Estimated Expense Amount
Travel (0.44 cents/mile)
Lodging
Meals ($36.00 daily max)
Registration Fee(s)
Other
Total
Purpose of meeting or absence (additional information):
Funding Code(s):
*
If unsure, ask supervisor/approver.
Funding Description:
Supervisor Email:
*
Employee Signature:
*
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