Sollon Communiitty Schooll Diisttriictt
So on Commun y Schoo D s r c
301 South Iowa Street, Solon, Iowa 52333
www.solon.k12.ia.us (319) 624-3401 fax (319) 624-2518
Teacher Quality Form – Part 1
Proposal for Use of Individual Teacher Quality Funds: Summer/Fall deadline October 15 , 2012.
Spring deadline April 12 , 2013.
(Teachers collaborating on a project must submit individual requests.)
Teacher Name: Date Submitted:
Project: (Include course/workshop name, if applicable)
Estimated Project Date(s): Estimated Project Completion Date: _ _
1. Describe the training/learning activities in which you will engage, including approximate dates
and course/workshop names, if applicable.
2. How will you participate collaboratively to share this learning with colleagues? You will be asked to
provide documentation of collaboration (i.e. meeting minutes) on the reimbursement form.
3. How will this activity help you grow as a professional? How does it connect with our district or
4. Projected Costs
Unit Cost (for
For what will you use these funds? example, per diem) Total
Substitute (days X $120) days $0.00
Time (per diem outside contract day – ½ day minimum) $0.00
Other (please specify):
Proposal Total $0.00
When submitting reimbursement forms, please remember to provide:
Proof of payment (1098-T, receipt from AEA, conference or college, bank statement acceptable)
documentation of attendance (certificate, email, etc.) or course completion (transcripts or email from
itemized receipts for travel including meals, lodging and parking.
notification that school vehicle was unavailable if requesting mileage reimbursement.
log of collaborative sharing or other activities mentioned on this proposal.
Applicant Signature: Date:
Signature of Receipt by TQC principal: Date:
Submission of Project Proposal does not guarantee disbursement of funds.
Date Proposal Reviewed by TQC:
Approved Returned for Revision Not Approved
Comments (if returned for revision): _____________________________________________________________
Make sure to include proper documentation (to verify time and costs) with your Request for Reimbursement.