Revised 7-12-16
DeSoto Parish School Board
Advanced Written Approval to Supplement Salaries
School/Department: ______________________ Funding Source(s): _____________________
(Workshop, Activity, Event)
Payment for stipends/supplements - 9 digit Account Code(s) ____________________________
Names of Personnel Participating (If more than 30, please list on another Advanced Written
Approval Form.)
1. ______________________________ 16. ________________________________
2. ______________________________ 17. ________________________________
3. ______________________________ 18. ________________________________
4. ______________________________ 19. ________________________________
5. ______________________________ 20. ________________________________
6. ______________________________ 21. ________________________________
7. ______________________________ 22. ________________________________
8. ______________________________ 23. ________________________________
9. ______________________________ 24. ________________________________
10. ______________________________ 25. ________________________________
11. ______________________________ 26. ________________________________
12. ______________________________ 27. ________________________________
13. ______________________________ 28. ________________________________
14. ______________________________ 29. ________________________________
15. ______________________________ 30. ________________________________
Dates (s) of Service: ___________________________________________
Number of Hours: ________ Rate of Pay: $___________ Total Projected Cost: $__________
Requested by: __________________________________ Date: _______
(Administrator)
Program Supervisor/Director: ______________________ Date: _______
Approved by
Superintendent or Designee: _______________________ Date: _______
Justification:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________