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Houston County Schools
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STATEMENT OF TRAVEL FOR PROFESSIONAL DEVELOPMENT
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Check all that apply below. Fill in blanks provided and attach appropriate documentation.
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Fund to be paid from
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Title of Workshop or Conference
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Dates of Activity
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Itemized Receipts attached
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Mileage form attached, if claimed
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Agenda attached
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Approved Professional Leave Form attached
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1.
Total miles traveled
@ $0.67 per mile
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Total mileage
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2.
Railway Fare
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Plane Fare
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Bus Fare
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Taxi
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Total Fare
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3.
Lodging ($350/night)
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Meals ($60/day)
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Miscellaneous
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Total Lodging, Meals, & Misc.
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GRAND TOTAL
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This is to certify that the above amount is due and unpaid.
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Signature of Claimant
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Claimant's Printed Name
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Address
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City, State and Zip
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Signature of Principal
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Signature of Central Office Personnel
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APPROVED BY
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Superintendent
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Date
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