PD Fund Out-of-Area Application 2020-2021

    Application Form Instructions

    • Applicants are expected to apply a minimum of 10 working days BEFORE the activity occurs in order for the SRTA PD Committee to consider the application prior to the date of the activity.
    • This completed application form will be submitted to pdchair@srteach.org.
    • Any changes in the activity approved by the SRTA PD Committee must be reported to pdchair@srteach.org immediately and is subject to an amending approval from the SRTA PD Committee.

    Please refer to the SRTA PD guidelines for each category’s application deadlines and descriptions.

    Fields marked with an asterisk (*) required.

    Member Information

    1. *Name of Applicant:
    2. *SRSD Email Address:
    3. *Date of application:
    4. *School/Workplace:
    5. *Member Status for 2020-2021:
    6. Effective dates of Term Contract or Leave of Absence:
    7. *Teaching Position:
    8. PD Description

    9. *Date(s) of activity: to
    10. *Location of activity:
    11. *Name and detailed description of PD activity:
    12. *In detail, indicate relevance of PD opportunity. (i.e. PGM, teaching load):
    13. PD Costs

    14. *Substitute days - (Number of work days the event covers):
    15. *Event Registration Fee: $
    16. Hotel Costs (room and taxes only): $
    17. *Per Diem Rate of $50/event day (covers meals and incidentals, not applicable for travel days): $
    18. Travel costs:
      a) Airfare (including airport taxes): $
      b) Taxi, limo or shuttle costs (between airport and hotel in PD location and airport and home OR alternatively parking at airport) $
      c) Kilometrage @ $0.55/km (as an alternative to airfare - if riding with others, mileage to be split amongst all riders): $
    19. *TOTAL COST of PD Fund Application (maximum per year is $2000): $