EXTENDED HOURS COMPENSATION APPLICATION
ALPINE SCHOOL DISTRICT


Name ______________________________  School ___________________________  Date: _____________

 

Social Security Number ________________________  Area of Instruction ____________________________

 

Is Your Regular Contract?   Full Time ________  Less than Full Time _______

 

 

AREAS AND HOURS FOR WHICH YOU ARE APPLYING:                                                                                # Hours


EQUIPMENT MAINTENANCE AND REPAIR                                                                                                        _______

CAREER AND TECHNICAL STUDENT ORGANIZATIONS (CTSO's)                                                               _______

PROFESSIONAL DEVELOPMENT (Can not be used for the USOE Summer CTE Conference)                      _______

PRE-APPROVED CURRICULUM DEVELOPMENT                                                                                                _______

TOTAL                                                                                                                                                                            _______

 

Justification for the request:
__________________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________


Instructor  ______________________________________

                                    Signature




Total Number of Hours Approved:  _________



CTE Coordinator  ______________________________________

                                               Signature



Revised 10-02-03                                                                                                                                  FORM CTE-004A