Professional Development Conference Request Form

Name *

First

Last

Email *

Today's Date *

School/Building *

Gillespie High School
Gillespie Middle School
Ben-Gil Elementary
Other

Explain how the conference content will be used in your course(s) curriculum: (If not applicable to curriculum, explain how the conference content will be utilized in the classroom) *

List the New Illinois Learning Standards that will be addressed: (If no standards are addressed explain how the conference will benefit instruction) *

Date / Time of Conference *

Date

Time

Website / URL of Conference

File Upload

Click or drag a file to this area to upload.

Please upload any Purchase Orders or Descriptions of Conference

Substitute Required *

Total Costs to Register for Conference *

Total costs of registration for conference, do not include other expenses.

Total Costs for Mileage Reimbursement *

Total costs for Mileage Reimbursement if District Transportation is unavailable.

Total Costs for Lodging Reimbursement *

Total costs for Lodging Reimbursement

Total Misc./Other Costs *

Total Misc./Other Costs, please explain costs below.