Professional Leave Application

Wendell School District #232

Professional Leave Application
Name *

First Name Last Name
Todays Date *

Month Day Year
Supervisor *
Subject/Grade *
Conference/Workshop Title *
Conference/Workshop Begins *

Month Day Year
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