PROFESSIONAL DEVELOPMENT REQUEST

Faculty/Staff
CURRICULUM OFFICE USE ONLY
Administrative Council: APPROVED: DATE: _______________ Approved amount $___________ Other Information: _______________________________________ DENIED: DATE: _______________

Other Action: _________________________________________________________________________

Please be advised, the following priorities will be considered: Request is linked to professional development goals as discussed with your principal Experience must directly enhance the educational process Relevance to overall UNIS initiatives and curricular areas receiving emphasis according to the curriculum cycle Relates to current assignment Quality, time commitment, location and cost of the event Previous number of conferences/workshops attended Support/approval of attendance from Principal/Supervisor Commitment to share the professional experience Well in advance of the event registration deadline, discuss your request for participation with your principal/supervisor and submit the completed request form to your principal/supervisor for signature. Once your request has been considered by the Administrative Council, your principal will inform you of your approval or denial. Upon approval by the Administrative Council, the Curriculum and Assessment Office will send you a green form requesting additional information needed for the arrangements of the event (i.e. registrations, travel plans, special requests, etc.). Please return the completed green form to the Curriculum and Assessment Office as soon as possible.

Please use this application for each Professional Development Request. Sections 1 through 5 must be completed (including estimated costs) before your application can be considered. Submit the completed form and relevant materials (event brochures, information, etc.) with this form.

Name of Applicant: ____________________________________________ Date of Application: _____________ 1. Specific event information: Title and description of the event: ________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________ Conference Date(s): From_____________________________ To________________________________ Are you a Member? ______________ If so, what is your Member #? _________________________

Location: _____________________________________________________________________________

Travel Date(s): From_________________________________ To________________________________

BE SURE TO ATTACH ALL SUPPORTING MATERIALS (including brochure and registration form) TO THIS REQUEST FORM FOR PROMPT AND ACCURATE PROCESSING. 3.2012

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How will this event have a direct impact on teaching and learning/job performance?

3.

How is this request linked to your professional development goals?

4.

Provide Estimated Costs: Registration: $________________ Hotel: $________________ Number of Substitution Days/Periods Needed: _______ **Per Diem: $________________

Transportation:

Air $__________ Train $__________ Car $_________ Taxi $__________

Estimated total cost: 5.

$________________

I agree to share what I have learned either as a written report and/or as a presentation. ____________________________________________ Date: ________________ Signature HOD signature of support (MS or TH faculty). ____________________________________________ Date: ________________

6.

7.

Principal/Supervisor signature of support. ____________________________________________ Date: ________________

Reimbursement of Expenses for Trips

When a faculty or staff member is approved for a school-sponsored trip, reimbursement for expenses will be made in the following manner: 1. ** A maximum per diem of $50 (domestic) and $60 (Intl) per day will be paid to cover meals. When an overnight hotel stay is included, an additional $15 is allotted for incidental expenses (i.e. telephone, minibar, newspaper, tips etc.). The amount of per diem will be paid depending on the time of departure and the time of return. No per diem will be issued for meals provided at the event or on a flight. Every effort will be made to assure hotel room, taxes and any registration fees are paid in advance by the school. Reasonable ground travel and/or air travel to and from the meeting location will be paid by the school. UNIS hopes that you will choose the most economical mode of transportation. Reimbursement will be approved by the Curriculum Office. The school will make the arrangements for transportation, lodging and event registration. responsible for checking VISA requirements for the country you are visiting. You are

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Upon return from the event please complete and return a reimbursement form to the Curriculum & Assessment Office, if needed.