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Private Schools - Professional Development Evaluation and Travel Reimbursement

Professional Development Evaluation and Travel Reimbursement

Name of Requestor: *

Street Address: *

City, State Zip: *

Email Address: *

School *

Description of Activity *

Location of Activity *

Date of Activity *

Post-Activity Evaluation

Please complete the following evaluation on the effectiveness of the professional development you received.

The trainer(s) demonstrated expert knowledge of the content presented. *

Resources/Information provided in the workshop will help me increase student performance. *

Resources provided in the workshop can be used to meet the diverse needs of all students including minorities, English learners, disabled, and economically disadvantaged. *

I felt comfortable asking questions/participating in the professional development. *

The content was presented was engaging and useful. *

Will you share this information with those who were unable to attend? *

Yes

Are you requesting reimbursement? *

Yes - Complete the Travel Reimbursement section below.

No - Please proceed to the bottom to sign and submit.

Travel Reimbursement Request:

ONLY complete if you are requesting reimbursement.

If you are requesting reimbursement for travel expenses incurred for professional development, you are required to have prior approval for the expense from the Director of Federal Programs and itemized receipts/documentation to support the amount to be reimbursed.

To process a Travel Reimbursement Request the following MUST BE ATTACHED:

Proof of Attendance for the conference, workshop or meeting
A copy of a map to verify mileage
A copy of the "$0.00" hotel receipt
Itemized receipts for any expense requesting reimbursement

Do you have prior approval for this professional development? *

Yes

Reimbursable Expenses: ONLY list expenses to be reimbursed.

Registration Cost	Total Travel Miles	Mileage Reimbursement (Miles x $ .655)	Meals - (Up to $59 per night w/overnight travel)	Hotel	Other (must specify below)	Total

Other Expenses: Specify

Description	Cost





Total

Required Attachments:

Please attach all required documentation.

Professional Development Registration/Proof of Attendance

List of Allowed file types

Map - Must include address using the shortest reasonable route:

Add attachment

List of Allowed file types

Hotel - Must include $0.00 receipt if paid through federal programs

Add attachment

List of Allowed file types

Other: Attach receipts for all other expenses

Add attachment

List of Allowed file types

Private School Requestor:

Type your name and sign below

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Approvals

A number of approval stages need to be completed before this submission can be accepted.

Private School Administrators

Please select the appropriate approvers from the Private School Administrators group below.
Please select your principal/supervisor

Holy Trinity

Our Lady Academy

St. Stanislaus

Federal Program Director

Appropriate approvers from the Federal Program Director group will be automatically allocated for this approval stage.

Federal Programs Secretary

Appropriate approvers from the Federal Programs Secretary group will be automatically allocated for this approval stage.