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Stipend Reimbursement Form 2026-2027
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Use TAB key to move between fieldsInvoice #
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IDENTIFY CO-SER:School Curriculum Improvement
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District Requesting Payment:
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Name of Activity
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Dates(s) & Hour(s) of Activity:
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Location:
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If applicable: Title of Corresponding BOCES-Related Activity/Date (within the past 18 months only) Include copy of approved in-district request form
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SIGN-IN SHEET(S) TO CONFIRM PROOF OF ATTENDANCE - MUST BE SUBMITTED WITH STIPEND REQUEST
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TEACHER'S NAME (Teachers Only)# HOURS
FOR TEACHERS ONLY		 Hourly Rate TOTAL (calculates)
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 $ 25.00 $ -
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TOTAL $ -
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Superintendent Signature or *Authorized SignerDate
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*Authorized signers must be identified by district and formally on file with BT BOCES Business Office
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Please email completed form(s) to the Professional Learning and Innovation Center at:
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plicreg@btboces.org
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Updated July 2026
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