DKC-C - Conference Leave Form
DKC-C
Certified Staff
Support Staff
Sublette County School District #9
Big Piney, Wyoming
APPLICATION FOR CONFERENCE/PD ATTENDANCE
Please Print or Type
Name_____________________________________________________________ Date:__________________________
Supervisor______________________________________ Job Assignment_____________________________________
Beginning_____________________ AM _________________________________________________
MM/DD/YYYY PM List dates absent other than start date (circle ½ days) Total Days
Conference/PD Title______________________________________________________________________________________
(Attach brochure or other information)
Location:_______________________________________________________________________________________
Sponsoring Organization:_________________________________________________________________________
Attendance directed towards: ________District Goal ________School/Dept. Goal ______Personal Growth Goal
Detailed explanation of purpose for attending:_________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Other District Participants: ____________________________________________________________________________
(Each participant must complete a separate request for travel reimbursement funds)
Your Cost Estimate:
Transportation –
School Car ( Vehicle Request to be submitted 2 or more wks. in advance)
Air Fare: $____________
Per Diem: ______days @______/day= ______days @______/day $____________
Lodging: ______days @______/day= $____________
Registration Fees: $____________
Other (please list):___________________________________________________________________ $____________
This request is for _______District Funds OR _______State/Federal Funds* (Must Check on or form will be returned)
(Principal/Dept.Head approval required) (Grant Manager approval required)
Employee’s Signature__________________________________________________ Date_______________________________
Substitute Required?____(Y/N) Comments by Principal/Supervisor____________________________________________________
_____________________________________________________________________________________________
Signature________________________________________________________________ Date of Action______________
Approved / Disapproved ___________________________________________ Date____________________
Superintendent
Comments:_____________________________________________________________________________________
_____________________________________________________________________________________________
07/01/23
Adopted: 6/20/23