LAUREL COUNTY SCHOOLS Out–of-District Professional Development/Travel Authorization (This Form must be completed and submitted to the Principal two (2) weeks in advance of the PD/travel.) Date Submitted ______Name of Attendee(s)______School ______Principal/Supervisor______

Title of PD Activity: ______PD Activity Type: Conference ____ Co-op ____ or State sponsored ____ Other ____

Content Area of PD: ______Appropriate for Grades: K,1,2…All)______

Location:______Complete Address: ______

Description______Facilitator/Contact: ______Facilitator/Contact Email: ______

Date(s)/Time:______# of PD hrs requested OR Stipend requested______

How does this PD relate to your PGP and/or CSIP? ______

(If applicable, complete for PD outside Laurel County and out-of-state. Note N/A where appropriate.) PD Registration Fee__$______X ______$______

(# of attendees) Lodging __$______X ______X ______$______(Rate per night) (# of nights) (# of attendees) Meals__$______X ______X ______$______(Cost per day-max $36/day) (# of days) (# of attendees) Personal Mileage______X __$______X ______$______(# of miles) (current mileage (# of attendees) reimbursement rate) BOE Transportation requested: Yes ____ No ____ (Contact Paula Robbins, 862-4600) Substitute X __$______X ______X ______$______(if applicable) (est. $100/day) (# of days) (# of attendees) Stipend ______X __$______X ______$______(# of PD hours) ($15.00/hr) (# of attendees) Other Expenses ______Total Estimated Expenses __$______Principal/Supervisor Signature ______Date Approved ______

Funding Source ______(If no fund source listed, expenses will be deducted from Section 6 funds.) Email a copy of this form to Denise Griebel at the Garland Building.

Note: 1. This Form must be received two (2) weeks in advance of the PD for approval. 2. Principal should enter requested PD as an Activity Proposal in CIITS EDS PD if not already listed. a. Teacher should be notified of PD approval and to register in CIITS EDS PD Module. 3. Approved Form will serve as documentation to the finance office to advance registration/lodging fees, reimburse travel expenses, etc. LAUREL COUNTY SCHOOLS Out–of-District Professional Development/Travel Authorization (This Form must be completed and submitted to the Principal two (2) weeks in advance of the PD/travel.) a. Send a copy of the Form to Denise Griebel at the Garland Building. 4. If applicable, a travel expense voucher should be submitted upon completion of travel. (Attach/sign applicable receipts)