CTR-1: CONFERENCE/TRAVEL REQUEST

BRIDGEPORT SCHOOL DISTRICT

CTR-1: CONFERENCE/TRAVEL REQUEST

PUBLIC SCHOOLS ONLY

This form is required for all funded and/or non-funded travel district staff may undertake.

It is your responsibility to review the district's Fiscal Management Guide (slides 81 through 84) for additional details and instructions related to the submission of this form.

Ensure that BEFORE you begin the completion of this form, you receive and/or have sought all required approvals, and have the necessary information needed to accurately complete, and submit this request at least THIRTY (30) business days prior to the event's registration deadline.

An attendee must receive a system-generated approval BEFORE proceeding with final travel arrangements or attending the requested event.

If attendance is approved:

Reimbursement may be required. Submit your request online by clicking on the “Reimbursement Request” form in the Budget/Business Forms and Fiscal Management Resources portal on the BPS website AND drop off your original receipts to the Grants Office.

SCHOOL YEAR*

2022-23

REQUESTOR: IDENTIFYING INFORMATION

Requestor: Name*

First Name

Last Name

Requestor: Email*

Confirm Requestor: Email *

Work Telephone Number*

Cell Telephone Number*

EMPLOYEE TYPE*

SCHOOL-BASED (based in a BPS school) DISTRICT OFFICE Employee BOARD OF EDUCATION Member

Principal or District Director: Name*

First Name

Last Name

Principal or District Director: Email*

SCHOOL-BASED EMPLOYEE

DISTRICT OFFICE EMPLOYEE

District Office Position Title*

OTHER: SPECIFY DISTRICT POSITION

DISTRICT OFF: Select DISTRICT APPROVER *

Superintendent Deputy Superintendent CAO: Chief Academic Officer - Jenkins Chief Financial Officer - Siegel Director, Adult Education - Denton Executive Director, Elem Ed #2 - Planas Executive Director, Elem Ed #3 - Morgan Director, SPED - Johnson TEST PROCESS

DISTRICT APPROVERS FOR DISTRICT EMPLOYEES

Refer to the chart.

DISTRICT APPROVERS - DISTRICT OFFICE EMPLOYEES

# ABSENCES TO DATE: IN SCHOOL YEAR

# Sick Days Absent*

# Personal Days Absent*

# Vacation Days Absent*

# Conference Days Absent*

# Other Days Absent*

If # Other Days >=0, please explain.*

Total # Days Absent to Date*

CONFERENCE INFORMATION

Conference Title*

Sponsoring Organization*

Purpose of Conference Attendance*

Is the Conference Destination OUTSIDE of the USA?*

Yes No

Check yes for international conferences.

Is Conference Destination OUT OF CONNECTICUT?*

Yes No

Is the conference taking place in the summer?*

YES NO

Destination Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Conference Start Date/Time*

Conference End Date/Time*

Absence Start Date/Time*

:

Absence End Date/Time*

:

# Work Days Absent for Conference*

Conference Flyer - Please upload.*

No File Chosen

File uploads may not work on some mobile devices.

Registration Form/Confirmation - Please upload*

No File Chosen

File uploads may not work on some mobile devices.

Request to Attend...*

With pay Charge to personal days

ESTIMATED COSTS

Registration Cost:* $

Travel Cost:* $

Mode of Travel - Check all that apply.*

Air Rail Personal Car

For Personal Car, Mileage (#Miles):*

Meals Cost:* $

Lodging Cost:* $

Other Costs:* $

If "Other Costs" are indicated, please explain.*

TOTAL ESTIMATED COSTS:* $

For Mileage, UPLOAD MAPQUEST printout.*

No File Chosen

File uploads may not work on some mobile devices.

FUNDING INFORMATION

EXPENSES PAID BY....*

Personal Expense Organization Sponsor No expenses are involved. BPS Budget Account

SELECT THE APPLICABLE BPS BUDGET:FUND SOURCE...

Select the School Operating Budget ONLY IF the principal has authorized use of the operating budget.

Select the Parent Involvement Budget ONLY IF the expenses are specified in the school's approved Parent Engagement Budget Plan.

Select the FNS Budget 01-900 ONLY IF you are a FNS employee.

Select GRANT: SCHOOL-SPECIFIC ONLY IF the school has a school-specific grant, in which the expenses are approved for funding.

Select GRANT: DISTRICT ALLOCATION, ONLY IF the CFO or GRANTS OFFICE has authorized use of the designated fund source in advance.

OTHER GRANT: SPECIFY Grant Title*

OTHER GRANT: SPECIFY Grant Account #*

REQUESTOR'S SIGNATURE

Click below to confirm that you have informed your principal or supervisor of this request to attend a professional conference.*

I have informed my principal or supervisor of this request to attend a professional conference

Date Submitted*

Requestor's Signature*

[clear]

Use your mouse or finger to draw your signature above

APPROVER: SCHOOL-BASED EMPLOYEE

School Emp Approver: Decision*

Approved Denied

SCH DENIAL: REASON*

APPROVER: DISTRICT OFFICE EMPLOYEE

District Emp Approver: Decision*

Approved Denied

DIST DENIAL: REASON*

APPROVER: BOE MEMBER, INTERNATIONAL AND OUTSIDE CT TRAVEL

SUPT: Decision*

Approved Denied

SUPT DENIAL: REASON*

CFO: REVIEW

CFO: Decision*

Approved Denied

CFO DENIAL: REASON*

CFO: COMMENTS

GRANTS MANAGER 1 - INIT

GM1: Decision 1*

APPROVED DENIED RETURN TO SENDER

GM1 DENIAL1: REASON*

GM1 RETURN TO SENDER: REASON*

GRANTS PROCESSOR*

Jacqueline Duenges Andrea Poulos Tina Cortello

GM1: COMMENTS1

GRANTS MANAGER 2 - FINAL

GM2: Decision 2*

APPROVED DENIED

GM2 DENIAL2: REASON*

GM2: COMMENTS2

GRANTS OFFICE: PROCESSOR

PROCESSOR1: DECISION*

APPROVED DENIED

PROCESSOR1 DENIAL: REASON *

Date Entered in MUNIS*

Requisition #1*

Requisition #2*

PROCESSOR1: COMMENTS

GRANTS OFFICE: PO#

PO#1*

PO#2*

PROCESSOR2: COMMENTS