Professional Day Request -- Total Cost to the District over $150
This form must be filled out for any request that involves school district travel expenditures over $150 as defined by NJAC 6A: 23A-7.1(d)travel that includes: transportation costs (mileage reimbursement), registration fees, substitutes, meals, lodging, etc. See School Board Policy #3440. The questions on this form are all required by law. It needs to be filled out fully and with great detail. Sanctions for violation of the travel policy include the reimbursement of funds at three times the cost. 6A:23A-7.7.

If changes need to be made after this form is submitted, please email them to Dana Cairy-Birdy.
First Name *
Your answer
Last Name *
Your answer
School/ Building *
Your answer
Department *
Your answer
In what capacity are you attending this event? *
Required
Your supervisor or principal must give approval prior to this form being filled out. Have they given their approval? *
If the answer is no, do not proceed until you have their approval.
What administrator(s) requested your attendance at this event or gave you approval prior to filling out this form? *
first and last name of an administrator - usually your supervisor or principal
Your answer
Name of Event *
Your answer
Date(s) of Event *
Your answer
Is this an all day event? *
Required
Briefly describe the event *
Be specific and don't use acronyms
Your answer
What other district personnel will be attending? *
Required: 6A: 23A-7.5 (b) 2
Your answer
Please provide a justification of the importance of attending the event. *
Required: 6A:23A-7.5 (b) 3
Your answer
The estimated cost to the district associated with the attendance at this event. *
estimated: mileage reimbursement, registration fees, lodging, tolls, etc.
Your answer
A brief statement explaining the primary purpose for attendance and key issues that will be addressed at the event and their relevance to improving instruction or the operation of the school district. *
Your answer
Is this training required for you to keep a certification that is required for the employment or to meet the requirements of the state or federal law *
What account number will you be using to pay these expenses? *
If you aren't sure, ask your supervisor. Substitute Account numbers: Lenape- 11 140 100 101 1 825, Shawnee - 11 140 100 101 2 825, Sequoia - 11 423 100 101 4 825, Cherokee South - 11 140 100 101 5 825, Cherokee North - 11 140 100 101 6 825, Seneca - 11 140 100 101 7 825
Your answer
What is the funding source for this trip? *
You can choose more than one answer
Required
Is this an annual event, please list the people who participated last year and the total cost for last year. *
Required: 6A:23A-7.5(b) 9 -- If no one attended last year, put "no attendees last year".
Your answer
Comments/Other necessary information
optional- If this request is an update to a previously submitted form or if any other information is necessary, please indicate below.
Your answer
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