Honorarium and Travel Expense Claim Form by daylah

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									 AAC Assessment Specialist Professional Development
              Expense Claim Form

Name:
Address:                                                 City

Postal Code                                  Phone:

Jurisdiction




Professional Development Session:
Date(s)            Name of seminar                                     Fee*

                                                                       $


    *   Please attach relevant receipt
    *   AAC will cover registration fees up to $70 per session that you attend as a
        participant, twice a year.


NB:     AAC will cover necessary substitute teacher costs (up to 2 sessions per
        year) to a maximum of $200. The jurisdiction is to send an invoice to the
        AAC office. They must reference the Assessment Specialist’s name
        and “AAC Assessment Specialist PD Support.”


I certify that this claim is correct and has been approved by one of the Field
Service Coordinators.


__________________________
Claimant’s signature


Please send this form and accompanying receipt to:

Alberta Assessment Consortium
#500, 11010 – 142 Street
Edmonton, AB T5N 2R1
                                                For
Fax: 780-447-2531                               office      Cheque No. _______
                                                use
                                                only
                                                            Date _____________



December 2006

								
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