Missouri Council of Administrators of Special Edu - MO-CASE Professional Learning Fund Application

* Name

Title

* District

* CEC/CASE/MO-CASE Number

* Email

* Phone (Best way to contact you)

* What conference or webinar are you applying for funding to cover? Dates and/times (webinar)

* How would you use the information gained from the conference or webinar?

* What would the estimated total cost be requested? Specify itemized requests (Hotel, registration and travel). You may attach an itemized list if needed.

Attach itemized list (if needed).

* Would a portion of your expenses be covered by your district? If so, how much?

* What other conferences or webinars have you attended this school year?

* I agree to take full advantage of the conference I attend. I agree to volunteer at the conferences, if available. I will give a report regarding the conference or a promotional blurb regarding the fund or a quote from the conference that can be shared

Yes
No

* I have permission from my direct supervisor to attend the conference.

YES
NO

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