1. Request for Approval of Cinergy Professional Leave

Requested by:

School/Office

Date request submitted:

Name of Conference

Training

Registration

(Circle One)

Purpose of activity,

Please include a description of how and what you hope to share with your fellow teachers upon your return from the conference.

(Please attach a copy of letter, brochure or other announcement by which you were informed of the need for this leave or a copy of the url where this opportunity is linked)

Which Cinergy initiative(s) will this activity support?

Check those that apply

___ Critical Thinking ___ Technology Integration

___ Scope and Sequences ___ Projects/ Research Process

___ Assessment ___ Primary Resources/ Community

___ Understanding by Design ___ Literacy

Date(s) of leave:

(if applicable)

Direct relationship of leave purpose to assigned duties

Are you for instance, a member of a FATS team and/or Project Partners?

Comments:

(FATS team leader)

FATS Team Leader