<p> CPS APPLICATION FOR PROFESSIONAL DEVELOPMENT, TRAVEL/MEETING, OR CONFERENCE</p><p>Directions: Step 1 – Requestor complete form and sign A) If Travel, Meeting or Conference, complete Page 1 ONLY and attach brochure or flyer B) If Professional Development through Mayerson, complete Pages 1 and 2 Step 2 – Acquire Supervisor, Accountant, and Grant Director/CAAS Rep (if needed) signatures Step 3 – If travel, meeting, or conference, Grants-Clerical Support will give log # and maintain original document Step 4 – If through Mayerson, Mayerson will give log # and maintain original document</p><p>School or Department: DATE: </p><p>Requested by: Dates of Activity:</p><p>Place of Activity: Person(s) Attending: Course or PD Title:</p><p>Estimated Cost Docume Per nt Description Amount Per Person X Account Code / Payroll Alias  Attache Person # of d persons APPLICATION FOR PROFESSIONAL DEVELOPMENT - MAYERSON Substitute Detailed $ Teacher Teachers List Teacher Extended Personnel $ Time Req Consultant Fee Consultant $ Total Offer Copies $</p><p>Materials / Supplies $ APPLICATION FOR TRAVEL, MEETING OR CONFERENCE - CPS Brochure Registration Fees $ $ or Flyer Transportation $ $ (airlines, bus, etc.) Mileage – personal $ $ car Lodging $ $</p><p>Meals $ $ Substitute Teacher(s) needed TOTAL $ $ $</p><p>Approval Signatures (Printed Names Will Not Be Accepted)</p><p>Requestor Date </p><p>Page 1 of 4 APD Form (Revised 11-2014) Supervisor Date </p><p>CPS Budget Office Accountant Date </p><p>CPS Director, Grants Administration Date </p><p>(required only if grant funded)</p><p>CPS CAAS Representative Date (required only if CAAS funded)</p><p>Page 2 of 4 APD Form (Revised 11-2014) PLANNING PROFESSIONAL DEVELOPMENT MAYERSON ACADEMY </p><p>NOTE: The following description provided here will be posted online.</p><p>Statement of Needs/Justification – WHY</p><p>If this PD activity requires multiple courses with different audience participants at each course, a separate course number is needed for each group of audience participants. Multiple sessions of the same course number require participants to attend all sessions.</p><p># of Participants per Course: ______# of Courses needed:______# of Sessions per Course:______</p><p>Course # Target Session Date(s) Session Time(s) Session Conta (to be assigned) Audience per Course # From/To Location ct per Course # Hours (1)</p><p>(2)</p><p>(3)</p><p>(4)</p><p>*Note: University Graduate Credit must be requested and approved through Mayerson Academy prior to the start of the activity.</p><p>Technology Food: Materials: Laptops # ______ Prestige Catering   Provided by presenter (Purchase Requisition attached) Promethean ______  Purchase Requisition  Other (to be reimbursed) attached</p><p>NAME OF PRESENTER:</p><p>NAME OF PAYEE (TO WHOM PAYMENT IS MADE, IF DIFFERENT THAN NAME OF PRESENTER):</p><p>ADDRESS OF PAYEE:</p><p>Phone(s): e-mail:</p><p>Consultant Fee: Consultant Travel/Lodging</p><p>Page 3 of 4 APD Form (Revised 11-2014) This professional development meets the Mayerson Academy Professional Development Standards.  YES  NO</p><p>Professional Development Specialist Date </p><p>Page 4 of 4 APD Form (Revised 11-2014) </p>