SCCS Professional Learning Application

Name*

First NameLast Name

Email*

youremail@swcrk.org

Phone Number*

Please enter a valid phone number.

Building / Department *

Position *

Principal/Supervisor Email*

example@example.com

Building/Department Secretary Email*

example@example.com

Title of Event *

Brief Description of Event *

File Upload - Event Flyer or Other Details

Event Location *

Street Address

Street Address Line 2

CityState

Zip Code

START Date & START Time*

Date

Hour MinutesAM/PM Option

END Date & END Time*

Date

Hour MinutesAM/PM Option

Do you need a substitute?*

full day1/2 day AM1/2 day PMno sub needed

Cost of Registration (please put 0 if event is free)*

$0.00

Funding Source*

If Unsure, please check with your supervisor before completing this form.

Alignment with District Improvement Goals *

Explain how this professional learning event aligns with district improvement goals or building needs. *

Are you a teacher in your first three years of teaching expecting to record this training for section 1526 credit?*

yesno

SECTION 1526 REMINDER: Following your participation in this planned professional learning event, please email the Human Resources Specialist to confirm your attendance at this event so the credit can be added to your Sec. 1526 form.

Is your training in Genesee County?*

yesno

When traveling outside Genesee County, you may be eligible to receive mileage reimbursement at the current IRS mileage rate (as of 1-1-2025 it is $0.70). Mileage must be calculated using Google Maps from your school or office to the event and a copy of the map must be uploaded when you submit this request.

If meals are not included in your event, you may be eligible for meal reimbursement. You must submit your receipts on your travel expense form. The maximum reimbursement for lunch is $15. If you are staying overnight and require dinner, the maximum reimbursement for dinner is $30. You must obtain and use a district credit card and ensure that our District tax exempt status is honored in the charge. Do NOT use your personal credit card and expect to be reimbursed! After your trip, receipts for food must be submitted when you submit your travel expense form.

If overnight accommodations are required and approved, please email ap@swcrk.org in the Business Office to be issued a District Credit Card before making any arrangements. You must coordinate and pay for your hotel accommodations
using this card to ensure that our District tax exempt status is honored in the
charge. Do NOT use your credit card and expect to be reimbursed! After your trip, receipts for your stay must be submitted when you submit your travel expense form.

UPLOAD GOOGLE MAP HERE - from your SCHOOL to the event location - showing total miles.

Are you requesting that the district pay for overnight accommodations?

yesno

Estimated Cost for Overnight Accommodations (price per night * number of nights)

Are you requesting that the district reimburse mileage?

yesno

Number of Miles from Your School Building to Event according to Google Maps

Mileage Reimbursement (round trip miles x IRS reimbursement rate)

Are you requesting reimbursement for one or more meals?

yesno

Please enter the maximum dollar amount that you might be requesting based on number of meals needed. (max is $15 for lunch and $30 for dinner)

Is your training outside of your contracted time?*

yesno

When attending training outside of your contracted days/times, you may be eligible for a stipend. Typically it is $50 for 1-4 hours and $100 for 5-8 hours. Are you requesting a stipend for this training?

Yes, 1/2 day stipend of $50Yes, full day stipend $1002 full days stipend $200No, I am not requesting a stipend even though the training is outside contract time.

SCCS Professional Learning Application

Each date should be entered on a separate form.