Conference/Time-off Request Form
Email
*
example@example.com
Select your immediate Supervisor:
*
Please Select
DiPace, Tony
Gray, Chris
Osterberg, Glen
Simpson, Melissa
Yorke, Tom
Name
*
First Name
Last Name
Start Date
*
-
Month
-
Day
Year
Date Picker Icon
Hour : Minute
AM
PM
AM/PM Option
End Date
*
-
Month
-
Day
Year
Date Picker Icon
Hour : Minute
AM
PM
AM/PM Option
Reason for request
*
Conference
Field trip
Personal Business
Sick/Medical
Vacation
Will you need a substitute?
*
Yes
No
Please explain any unusual situations, reason for request, or substitute preferences.*
*
*Every effort will be made to accomodate specific requests, but nothing is guaranteed.
PLEASE STATE NAME & LOCATION OF CONFERENCE/WEBINAR AND INDICATE HOW YOUR ATTENDANCE AT THIS EVENT WILL ENHANCE YOUR ABILITY TO PERFORM YOUR DUTIES AND/OR IMPACT STUDENT PERFORMANCE.
*
The NCLB act requires all public school personnel to take part in high quality professional development (PDP). Effective professional development must be grounded in scientifically based research, should enhance instruction and produce a measurable effect on student academic achievement.
Please select any costs to attend the training that you want SSCS to pay for.
Lodging
Registration
Meals
Transportation
Other (Please specify)
Total cost of lodging.
*
Total cost of meals.
*
Total cost of registration.
*
Total cost of transportation.
*
Total cost of other noted expenses.
*
Will you need a school vehicle?
*
Yes
No
Type of vehicle/driver requested.
*
Car
Bus
With driver
No driver needed
When do you need the vehicle?
*
Departure and Return Times
Destination
*
Destination Name
Street Address Line 2
City
State / Province
Postal / Zip Code
Please note: Staff members are encouraged to use a school vehicle. If no vehicle is available or there is an extenuating circumstance where use of a school vehicle is not practical, then that should be explained in writing and preapproved by the Superintendent before reimbursement will be authorized.
*
Check to acknowledge your understanding of the mileage reimbursement policy.
Check to explain any extenuating circumstances.
Upload any relevant information.
Browse Files
Drag and drop files here
Choose a file
(ex. completed registration forms, brochures, etc.)
Cancel
of
Provide any relevant details/websites.
(ex. online registration, hotels, attendees, etc.)
TOTAL COSTS TO ATTEND
If approved for overnight travel, you will need to sign out the district credit card and obtain tax exempt forms from the District Office before you are scheduled to leave. As a reminder, your costs are covered as spelled out by the SSCS BOE Policies 8.22 and 8.28. Meals will be covered at a rate of approximately $30 per meal while you are travelling on behalf of the District. Itemized* receipts for all expenses must be provided to the District Office upon your return. Any expenses that are not accompanied by itemized* receipts cannot be approved and will be the responsibility of the individual who signed out the district credit card. The District has sales tax exemption forms for you to take with you on the trip, if applicable. If you have any questions, please ask before you travel. (*Itemized receipts include a breakdown of all individualized items/expenses charged.)
*
Please check to acknowledge receipt of this Credit Card Use Agreement and accept responsibility as per SSCS BOE policy as located at https://www.sharonsprings.org/board-of-education/board-policies/#.ZEaErc7MI2w.
Personal Business is any activity that cannot be completed outside of regular work hours. By selecting this option, you attest to the fact that the time away from SSCS will be spent taking care of Personal Business that could not otherwise be tended to outside of your normal workday and that - to the best of your knowledge - you have enough personal time available to cover the request.
*
Yes
No
Sick/Medical leave is reserved for pre-scheduled medical appointments or medically relevant leaves of absence for the employee or an immediate family member. By selecting this option, you attest to the fact that the time away from SSCS will be spent at a pre-scheduled medical appointment or for medically relevant leaves of absence for yourself or an immediate family member and that - to the best of your knowledge - you have enough sick time available to cover the request.
*
Yes
No
Vacation time is available per contract. By selecting this option, you attest to the fact that - to the Type a questionbest of your knowledge - you have enough vacation time available to cover the request.
*
Yes
No
Submit For Approval
Should be Empty: