Professional Leave Application

Wendell School District #232

Professional Leave Application
Name*

First NameLast Name
Todays Date*

MonthDayYear
Supervisor*
Subject/Grade*
Conference/Workshop Title*
Conference/Workshop Begins*

MonthDayYear
Number of Days Gone*
Conference/Workshop Location*
Requesting Registration Fees*
Registration Fees
Requesting Lodging, Meals, and/or Mileage?*
Lodging Costs
Mileage Driven
Meals Requested (Please do not include meals provided at conference/workshop)
# Dinners
# Lunches
# Breakfasts
Please describe how this professional development correlates with school, district, and personal goals.*
Employee Signature*
By checking this box I agree my electronic signature is the legal equivalent of my manual signature on this Agreement*

Agree
The following is for administrative use only.
Supervisor Signature
Supervisor Code
Approved
Superintendent Signature
Superintendent Code
Approved
Should be Empty:

Wendell School District #232