	Professional Leave Request Form Columbia County Board of Education (Approved form must accompany all Travel/Registration Reimbursement Requests)

Department/School Making Request:
Name of Person (s) Making Request:
Dates of Leave Requested: Destination (City & State):
Purpose of Leave Requested:
Allotment (Please select the appropriate category)

X	Category	# of Days
	School		(requires principal's signature)
	Department		(requires department head signature)
	Administrative		(requires supervisor's approval)
	Non-certified Employee		(requires administrator's approval)
	Professional Employee not under contract		(requires administrator's approval
	State Meeting: Department Use Only		(requires department head's signature)

                                                                 Substitute Required: YES   NO

                                                                 Absence Reporting (VIPS) & Substitute Funding Source
                                                 Please select & record the absence in VIPS based on the following code.
                                         You must complete this portion and report the absence, even if no sub is required
X VIPS Code Sub Funding Source X
VIPS Code
Sub Funding Source

11 Local/Federal Funded Special Education 32 School Local Funds (Princ. Account)

13 School Professional Learning Budget 37 K-3 Reading/Math Grant (Dept. Approval)

*14 System/Dept. Professional Learning (Dept. Approval) 40 Title II Prof. Learn (Assoc. Supt. Approval)

*15 Curriculum Development (Dept. Approval) *43 National Board Cert. (HR Approval)

18 Gifted (Dept. Approval) *44 SACS (Assoc. Supt. Approval)

19 Title I Grant (Dept. Approval) *46 Paraprofessional Testing (HR Approval)

*26 Strategic Planning (Assoc. Supt. Approval) 47 PDS Augusta State (Princ. Approval)

*29 Lottery Pre-K (Dept. Approval) *49 Educational Leave (Assoc. Supt. Approval)

*51 School Nutrition Prof. Leave (Dept. Approval)

*Days using these funding codes will not be subtracted from any school allotment

  Projected Cost of Trip  $    Source of Funding

                       __________________________________________________                       _______________
                                Signature of Principal and/or Department Head                                                 Date
             _______________________________________________________________________________________________
                                                          Submit this form to the Superintendent's Office for verification

               Allotment Verified by: _____________________________    Approved by:______________________________

                             Date signed: _________________                             Date Returned:___________________