LOS ANGELES COMMUNITY COLLEGE DISTRICT
Encumbrance #
DIVISION OF HUMAN RESOURCES
Reference #
REQUEST FOR CONFERENCE OR ACTIVITY ATTENDANCE
Directions: Submit top two copies to President or Division Head.
Attach conference or activity program, announcement or other descriptive document
.
1.
Name of Employee
Empl. No.
College or
Division
- LACCD
Job Title
2. Name of Conference or Activity
3. Sponsoring Agency
4. Conference/Activity Location: City State
5. Conference/Activity Schedule: Opening Date Closing Date
6.
Dates on which employee will be traveling and attending conference or activity (include weekends and holidays):
Beginning Date
Ending Date
7. Will paid substitute be required Yes ______ No
8.
Purposes and anticipated value to the District which will be derived from attendance:
9.
Indicate additional assignments:
NA
Location
Will paid substitute be required? Yes No
X
10. *Estimate amount of expense requested:
Transportation $
Hotels & Meals $
Registration Fee $ Incidentals $
TOTAL $
11.
Signature of Applicant:
Date
12. This section to be completed by College President or Division Head:
a. ( ) Refer to Chancellor
( ) Rejected
b. ( ) General Funds
( ) Special Funds
Account No.
M000-
-
-586100
c. Amount of Conf
erence
expense recommended
$
President or Division Head
Date
13.
This section to be completed by Chancellor or President/Division Head:
( ) Recommended with expenses recommended in item #12
( ) Not Rec
ommended
President/Division Head Date
Enc. Amount _____________________________
Account _________________________________
CFA ___________________ Date ____________ Processing Date
*The REQUEST FOR CONFERENCE OR ACTIVITY ATTENDANCE is a form used to request authorization for a business trip or a program of approved
training or study (webinar). The REQUEST FOR CONFERENCE ATTENDANCE is required for authorization under the following conditions:
a. Trips outside the 100-mile radius of the Los Angeles City Hall
b. Overnight absences from an employee's established residence involving any reimbursable expenses
Check here if requesting for conference advance (Attach advance request form)
Check here if advance registration fee payment is requested.
Registration fee will be paid directly to the conference organizer, please provide invoice
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