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FOR PAA MEMBERS ONLY PIONEER TEACHER CENTER REQUEST FOR REIMBURSEMENT APPROVAL 1. In accordance with the PAA contract, the employee will fill out a request for course approval with an explanation of how it will fit into the staff member’s professional development and can be used to assist in raising the standards for students.2. At the completion of the course, the employee will submit an evaluation of success in the program, how the course will be implemented into their classroom and professional duties and a copy of the course completion certificate or record of grades. Staff members who fail to complete the prerequisite forms and follow-up may lose the right to earn the cash reimbursement associated with this contract. Name: _________________________________________ Building: ____________________ Course Title: ___________________________________________________________________ Course Dates: ____________________________________ # of Units/Hours ______________ Course Provider: ________________________________________________________________ Years of Service: ____________ Cash (must have at least 3) ____ Tuition (must have at least 5) support the school district’s mission, expected student outcomes and learning standards; and your school’s action plan goals:____________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Required Action Steps: Attach a copy of the course description. Applicant’s Signature: _______________________________________________ Date: ___________________ PAA or PFA Advisory Board Member Initials: ____________________________ Date: ___________________ Principals’/Supervisor’s Signature: ______________________________________ Date: ___________________ Inservice Board: Approved/Disapproved Date: __________________ Superintendent/Designee Signature: _____________________________________ Date: ___________________ |