Phenix City Schools Individual Professional Learning Request

This form is to be completed by any Phenix City Schools staff member who wishes to request approved leave during a contracted work time period and/or to request funding for a professional learning opportunity. The form must first be reviewed for initial approval by the direct supervisor before being routed to the Teaching and Learning office for final federal program budgeting approval, if necessary.

Supervisors must approve of any staff member's absence during contracted times before any other approval considerations (i.e. AESOP Detached Duty or Professional Development absences). Building principals must also review the remaining Classroom Instructional Support Funds (CISF) for Professional Learning funding to cover any requests that would be in accordance with the committee-approved and submitted budget.

Athletic and extracurricular activity funding is the responsibility of the team, club, or school of the staff member requesting leave.

District federal programs funding will only be considered for district-sponsored initiatives or requests for learning opportunities to be added as district-sponsored that are approved. Preference will be given to staff that attend summer sessions, as requested by the school/district administration, when applicable. Requests for professional learning opportunities may require follow-up task completion or turn-around training to obtain approval.

Personal Information

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Staff Site Location or Position for Request - School principals should select Principals. - Athletic coaches for athletic events should select Athletics. *

Staff Site Location for Accounting *

Please note that the superintendent must provide final approval for any school administrator or Executive Services Council member detached duty.

Primary Employment Position *

If you selected other for your primary position, please provide your job title.

Please provide your primary area(s) of instruction or support. *

Please select your primary grade level(s) served. *

Leave and/or Professional Learning Request Information

Will this professional learning opportunity or other PCS employment-related task occur during a contracted workday(s)? *

Yes

No

Please upload a verification of initial approval/request for detached duty from the appropriate supervisor. *

Which of the following Phenix City Schools initiatives does this pertain to? *

Please upload a flyer or information documenting the requested professional learning. *

Please provide a detailed description for this request. *

Please select the start date of this opportunity. * +

Please select the end date of this opportunity. * +

Please provide the benefits of the allowance of this leave and/or professional learning (i.e. supervisory support of students, any follow-up training that can be provided to school system colleagues or school/system needs that can be met as a result of your participation in this professional learning opportunity, etc) *

Projected Expenses

Please select any school, athletic, or extracurricular funding that will be used for this opportunity. *

Please select any district or federal funding that will be needed for this opportunity. *

Local District Funding (prior approved, non-federal)

Special Education Funding

Title II Funding (PD)

Title III Funding (EL)

Title IV District Funding (Approved Budget)

No district funding requested

Registration Amount Needed *

Lodging Amount Needed *

Airfare Amount Needed *

Vehicle Mileage Payment Needed (0.67/mile) *

Meals Amount Needed *

Parking Amount Needed *

Other Amount Needed *

Please describe if "Other Amount Needed" is greater than $0. *

Total cost of professional leave opportunity. *