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SCHOOL LEAVE
Please complete this form for all school leave requests - NOT COACHING
*Send all registration information to Stacey Wempen at Central Office. Central Office will make all hotel, airfare, and other needed arrangements.
* Indicates required question
Email
*
Record my email address with my response
School leave employee name:
Your answer
Name of professional or school leave
*
Your answer
Leave Dates:
*
Your answer
Location of professional or school leave
*
Your answer
Type of school leave:
*
Meeting
Professional Conference
Student Trip
Workshop/Training
Other:
Required
Goals met with this conference:
*
Prepare Students to be College/Career Ready
Ensure Effective and Efficient Operations
Personal Goal
Required
Justification for attending:
*
Your answer
List other participants attending the same conference/meeting. If you are the only one attending, enter SELF
*
Your answer
If this is out-of-state travel, have you given TWO MONTHS notice:
*
Choose
Yes
No
N/A
Registration fee - Enter $0 if no fee is required
*
Your answer
Do you need a substitute? If you need a sub, you need to enter your time off in TimeClock Plus. It is your responsibility to make sure this leave is approved by your supervisor and that you have a sub for the time.
*
Choose
Yes
No
If out-of-state, do you need airfare?
Choose
Yes
No
Estimated cost for airfare:
Your answer
Do you need lodging?
*
Choose
Yes
No
If yes, preference/comments:
Your answer
if Yes above, hotel arrival date:
MM
/
DD
/
YYYY
Hotel departure date:
MM
/
DD
/
YYYY
Estimated hotel/lodging cost:
Your answer
Estimated per diem amount (in-state: Breakfast $7; Lunch $15, Evening Meal $23) (out-of-State: per
gsa.gov
guidelines per day); if this is a day trip, no per diem will be reimbursed. See policy and staff handbook for complete guidelines.
*
Your answer
Other estimated costs (baggage fees, etc.)
*
Your answer
Is this General Fund (GF), Grant, or Student Activity (80) funding?
*
General Fund - Building - ELEM Principal Approval
General Fund - Building - MS/HS Principal Approval
General Fund - District - Superintendent Approval
Grant - Superintendent Approval
School Activity
Other/Unknown
Other:
Required
If this is student activity fund, please indicate the activity account as well as the dollar amount of funds in the account.
Your answer
If this is funded by a grant, please select the Grant name.
Title I - Superintendent Approval
Title II - Superintendent Approval
VIB - SPED Director Approval
Unknown
Other:
Will you be requesting a school vehicle? (If you choose to drive a personal vehicle, you may not be reimbursed for gas receipts or mileage)
*
Choose
Yes - Complete Transportation Request Form Here: https://forms.gle/NEMZzjhBavn8Mmee7
No
Will you be requesting Student To-Go Meals from the Food Service Department? If yes, please complete this form at least two weeks prior to trip: https://forms.gle/kuiboStUwue88rJu9
*
Choose
Yes - Complete Meal Request Form Here: https://forms.gle/kuiboStUwue88rJu9
No
Comments:
Your answer
A copy of your responses will be emailed to .
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