PROFESSIONALLEAVEREQUESTFORM
1. Must be submitted 60 days prior to event.
2. Attach separate page of back-up documentation on event, dates, and costs for approval at PWS/Regular BOE
meeting.
3. Process a purchase requisition for the registration and attach to and submit with the professional leave.
* Note the Board meeting date.
4. After approval of Professional Day, call for a Substitute if required: FOLLOW AESOP PROCEDURES
5. Submit a Summary Report to your Supervisor, after the workshop.
6. Prepare Turnkey presentation for staff where applicable.
Date of Application ____________________________ Date(s) of Trip: ______________________________________
Staff Member’s Name: _________________________________ District Location: _____________________________
Assignment: (Course/Grade Level)/Position: _____________________________________________________________
Description of Event: ________________________________________________________________________________
Location of Event: __________________________________________________________________________________
Approximate Costs: (please check if it was necessary for EMPLOYEE to PRE-PAY)
Registration: _________ Charge to Account #: _________________________ Total ___________
Mileage: ________ Tolls: ________ Mass Transit: ________ Charge to Account #: _________________________
Total ___________
Lodging: ________ Meals: _________ Misc/Parking/etc: ________ Charge to Account #: _________________________
Total ___________
Total Costs: $ ___________
Employee’s Signature __________________________________ *Substitute Required Yes No
______ *Leave approved; No subs available on date(s) requested. Provide Internal Coverage
Approvals/Signatures:
Principal: ___________________________________________________________________ Dated: ___________
Director: ____________________________________________________________________ Dated: ___________
Superintendent/Assistant Superintendent: _______________________________________ Dated: ___________
Approved at BOE Meeting: ___________ Date: ___________ Denied: __________
Reason for Non-approval: _________________________________________________________________
This form is available on the District Website under Resources; Staff Resources
Please keep a copy of this form for your records before submitting!!!
DWO3- revised: 12/18/13
