HomeMy WebLinkAboutOut of State Travel Request - Renew (002)GRANT COUNTY
COMMISSIONERS AGENDA MEETING REQUEST FORM
(Must be submitted to the Clerk of the Board by 12-OOpm on Thursday)
REQUESTING DEPARTMENTRENEW DATE, Q7/'I 3/2026
REQUEST SUBMITTED BY.Raquel Fike PHONE, 509-765-9239
CONTACT PERSON ATTENDING ROUNDTABLE.Del) Anderson
CONFIDENTIAL INFORMATION: AYES ENO
L--jAgreement / Contract
L-7AP Vouchers
7--,! Appointment / Reappointment
Related
0Bids / RFPs I Quotes Award
I[ Bid Opening Scheduled
E] Boards / Committees
Budget
17 Computer Related
County Code
ElEmergency Purchase
Employee Rel.
[]Facilities Related
[]Financial
17Funds
Ell" earing
Invoices / Purchase Orders
E!]Grants — Fed/State/County
IDI-eases
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*Out of State Travel
Petty Cash
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Letter
:!Surplus Req.
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You's
ElTax Title Property
7WSLCB
Isidro Alvarez traveling
to Atlanta, G Oct 4-8,
2026 to attend CrisisCon26. This
will benefit clinical knowledge during deescalation of crisis situations.
--- - ------------- ----------
Ui-
jr
If necessary, was this document reviewed by accounting? Cl YES
APPROVE.- DENIED ABSTAIN
D1:
D2:
D3-
7! NO N/A
.. = N/A
4/23/24
Out of State Travel Request Apptication
DEADLINE: Due by Thursday at 12.:00 pm. to theCommissioner's office with BOCC Consent Agenda Request Form, to be on the
following WeeWs Consent.Agenda.
Traveler's Name : Isidro Alvarez
Department/Off ice: RENEW-Crisi
Purpose of Travel,.,
destination:
�risis�on��
Atlanta, GA
Cates of Travel: 0/4/ o -1o/8/ 02
Totat Trip Cost Estimate:21755.52
(This line will auto -suit the costs listed below)
Travel Type (Select One):
Fund Number/Department-,
0 Out of state Travel
0 Out CONUS Travel (AK, HI or US Territory)
0 Foreign Travel
0 Extradition
Grant Funded" If Yes, List Grant Amount:
Cost Application (Select One)
0 Yes
Government Rate
0 No
Conference Rate
------------
Regular Rate
Motel ` GSA Rate: Hotel ` Nightly Rate:
Hotel Total:
182.00
---------------
219.001 1)0"- 04
Explanation for Rate: Required if hotel cost is greater than per them orgoverr meat rate Conference Fee:
The Cr1sjsCon26 conference will be herd at the Hilton, they blocked out
rooms at Is 902.98
the discounted rate. This eftinates travel to/from any other hotel.
Rental Car Required? If Yes, Rental Car Cost:
--------------
Total Estimate of MI E During Travel:
0 Yes
$ 280.50
No
Air Carrier: Cost of Flight:
528.00
Delta
(Addt`l costs for extended stays, flight
upgrades, etc. at the expense of the traveler)
Preparers Name/Title: Preapproved by EO/DH? If Yes, EQJQH Name:
Yes
R el File Payroll An l
aqu � � a yst
wart I'adtlla
0
No
TRAVEL ALLOWANCE CLAIM
COUNTY AUDITOR
GRANT COUNTY, WASHINGTON
Claimant: [Isidro Alvarez Claimant's Dept.: IRENEW-Crisis
Purpose of Travel: [Crisis Conference 2026 Destination: lAtlanta, GA
MEALS
DATE
BF
L
D
IE
TOTAL
10/4/2026
$16.50
$17.25
$27,00
$3.75
$64-50
10/5/2026
$22.00
$23.00
$36.00
$5.00
$86.00
10/6/2026
$0.00
$0.00
$36.00
$5.00
$41.00
10/7/2026
$0.00
$0.00
$36.00
$5.00
$41.00
10/8/2026
MOO
$17.25
$27.00
$3.75
$48.00
----- -- ---- ---- ------
$0,00
$0,00
TOTAL 1 $280.50
CERTIFICATION
1, the undersigned, do hereby certify under penalty of perjury that the
claim is a just, due and unpaid obligation against the County, and that I
am authorized to certify to said claim.
Claimant Signature:
Date:
r WAMWWMWW.�WW.0MWAr"WWJ
0 TRAVEL VERIFICATION
0 0
1 1
0 TO BE COMPLETED UPON RETURN ONLY 0
0 0
11, the undersigned, do hereby certify under penalty of perjury that the I
oplanned travel referenced on this form did, in fact, occur on and for the 0
Iduration of the dates provided on this form. Additionally, I attest that I
Othe allowance provided prior to travel was rightfully owed to me as a 0
Iresult of this travel, I
0 0
Vlaiman.t Name: I
0
JCiaimant Signature:
0
Irate:
0
IAMW Iff 1�r w AMW ff.ANW Ar AMW Aff A� 1W AWW Ar AMW.W AWW.W ANW Ar AMWW AWWff.�W.W.� W
0Departments shall maintain a copy of this form, The travel verification
0 section must be completed, on the Department's copy, upon the 0
1 employee's return frorn travel. The department shall retain the fully I
(completed copy for six years or in accordance with the Washington StateO
I Records Retention Schedule (GS2011-184 Rev. 3). 1
AW AMW Ar �r aff AMW Ar MWJV AWW AW AMW W AWW IV "W Ar "W AAMW AW AMW Aff AMW W AMW W AN
MILEAGE
DATE
FROM (crry, s,i-)
TO (arty, si-)
MILES
RATE
TOTAL
$0.725
1$0.00
$0.725
$0.00
------ --------
$0.725
$0,00
$0,725
$0.00
$0.725
$0.00
TOTAL
— - -- - -----------
*TOTAL REIMBURSEMENT CLAIM [..:�$280.50
*Amount may be different due to rounding*
Authorization required for Employees:
ELECTED OFFICIAL, DEPARTMENT HEAD, OR DESIGNEE
Narne (printed):
Signature:
Date:
Authorization required for County Commissioners or Elected Officials,
COUNTYAUDITOR
Name (printed):
Signature:
Date:
Authorization required for the County Auditor, Department Heads, meals expenses
outside of travel status, and out of state travel:
COUNTY COMMISSIONERS
Commissioner
Commissioner-.
Chairman BOCC:
Date:
reg istration
Thank it -vou fo
Y egr r'ist * #
ering using Whova
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CrisisCon26
October 5 - 8t 2026
Hilton Atlant-a
"-'5ourtlan1-d S- NE
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Contact information
' *gfa s 9
#rder Summary
Emc,fll, rfiike(��grantcoun,,!'--' gj Q
-FF2B31DYVgOldj'bg7S
Orde, D, in I I rif ir-'Icl 1" k,) ch 3TsIg
Order chatterJuly 13,,2026 08:22 Am
Tickets Price
I x Non -Member - Full Conference
Attendee: Isidro Alvarez
Whova Registration 1D.' WHV-TUUI-7-5!P
or secl.sit y p-j-posres.. ie
Subtotal $850.0Q
Fees 5 2.9 8
Order Total $902.98
event and conference platform
Ballow us on social media
Raquel Fike
From: Whova Team <event-noreply@whova.io>
Sent: Monday, July 13, 2026 8:23 AM
To: Raquel Fike
Subject: CrisisCon26: Registration Confirmation
"EXTERNAL EMAIL**
This email originated from outside Grant County's network. Do not click links or open
attachments unless you r-ecogni - zcl the sender and know the content is safe.
D--
CrisisCon26
CrisisCon26: Registration Confirmation
You have successfully registered for CrisisCon26! The order details are below. Please
keep this email as a receipt for future reference.
Event will be ready on web and mobile soon!
You will be notified once the event is ready on the Whova Web and Mobile apps. You will
then be able to access the agenda and network with other attendees.
Message from the organizer
O
The Crisis Residential Association and the ' International Council for HeIRlines are excited
to have you join us in Atlanta for CrisisCon26, October 5-8, 2026! Please see below for
important information, and contact us at info(&,crisiscon.com with any questions!
Hotel Information:
Hilton Atlanta
255 Courtland St NE, Atlanta, GA 30303
Hotel Reservations:
0 Book your room at the Hilton Atlanta here:
CrisisCon Room Block
• Rate: $219 + tax per night (rate excludes all fees)
*The discounted hotel rate is guaranteed only through Friday, September 4th, 2026.
Rooms are limited; we cannot guarantee a room for all attendees, so book as soon as
possible! Reservations made after September 5th are subject to availability and prevailing
hotel rates.
On -Site Parking: Daily: $40.00 Valet: Daily: $60.00
Note: Parking is managed by a third party and is First -Come, First -Served. Parking is not
guaranteed; no reserved spots
Event Schedule:
Pre -Conference programming is available on Monday, October 5th (for an additional fee).
But otherwise, the CrisisCon Welcome Reception takes place on Monday and goes from
5:30 - 7:30 PM. The conference concludes on Thursday, October 8, at 12:30 PM.
Please check the CrisisCon website for the most current schedule
updates: https-://www.crisiscon.o
Dress Code & Weather:
The suggested dress code for CrisisCon is Business Casual/ Smart Casual. Please keep
in mind, meeting rooms can run on the cool side. The temperature this time of year in
Indianapolis can range from mid-70s during the day to mid-50s during the evening.
Conference Merch:
Show your support for CrisisCon and grab your official merch when you register!
Thank you to our Platinum Sponsor:
0
Interested in Sponsorship or Exhibiting? Reach out to inf @crisiscon.o
Cancellation or Registration Transfer: We understand plans change; below is our
cancellation/transfer policy. Please let us know if you have any questions.
Refund -and Transfer P Conference registration is non-refundable. You are welcome to transfer your
ticket to a different individual until September 12. To transfer your registration, please complete the
form linked here. If you believe you have a special circumstance, please contact us at info (a'�cnsi I scon-o
with details. Your request will then be brought to the conference committee for case -by -case review.
rr:.: Share with your friends and colleagues
Help us get the word out about CrisisCon26! Share that you're going to the event and
encourage your network to register.
E�*hare on Lin Cedin
••,3§hare on X
//"+.7h uM 4
Zv�
i
Online order details
Purchaser: Raquel Fike
Email: rfikeggrantcountywa.gov
Order Confirmation: ch-3TslgjFF2B31DYVg0ldjbg7S
Credit Card #: ****6613
Order Date: July 13, 2026 at 11:22 AM
Website: https://vwhova.com/portal/registration/Jspker4AlODcUbuxlFAi/
3
Tickets Price
1 x Non -Member - Full Conference $850.00
Fees $52.98
Attendee: Isidro Alvarez
Whova Registration ID.- WHV-TUUZ51P
For secuntly purposes, please do not share this ID with anyone else.
You may edit this registration information within 24 hours of your purchase.
Ticket Subtotal: $850.00 (USD)
Fees: $52.98 (USD)
Order Total: $902.98 (USD)
Still need to buy an add -on or extra ticket?
Add to your order
... . .. .
" 151 .
Event details
IN"Yd
11110 "W*
CrisisCon26
Monday, October 5, 2026 - Thursday, October 8, 2026
Add to your calendar: Goode Outlook iCal Yahoo
Hilton Atlanta
255 Courtland St NE, Atlanta, GA, 30303, US
View venue on Google Maps
Contact Info:
info@crisiscon.org
a]
Questions &cancellation policy
Questions
Contact your event organizer with any questions you have about this event at:
info@crisiscon.org
Cancellation policy
The cancellation and refund policies are set b►y the event organizers. Please contact
your event organizer directly to request a refund.
Use Whova for your event
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Event ticketing and online registration by Whova
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This message was sent through Whova. Your email address and contact info are not disclosed to the public.
1AIhnw,q FAOc--
Raquel Fike
From: Hilton Hotels & Resorts Confirmed <noreply@h6.hilton.com>
Sent: Monday, July 13,2026 7:58 AM
To: Raquel Fike
Subject: Your Oct-04-2026 Confirmation #3497335042
no
Hello Isidro,
See you soon, Isidro Alvarez
Your reservation for Sunday Oct 04, 2026 has been confirmed.
Confirmation # 3497335042
Hilton Atlanta
255 Courtland Street NE, Atlanta, GA,
30303 US
Join now --*
+14046592000
[] View your stay in app
Add to calendar (iOS/Outlook)
Q Add to calendar (Other)
Sunday Thursday
Oct 04 4 Oct 08
Check In: 4:00 PM Nights Check Out: 11:00 AM
1
Your Room Summary:
Guest dame Isidro Alvarez
Guests 1 Adult
Rooms 1
Room Plan 1 KING BED
Rate Type CRISISCON 2026
CC Auth will be needed
Comments & Requests
Modify Your Reservation -+
N
Rate Rules and Cancellation Policy
• There is a credit card required for this reservation.
• If you wish to cancel, please do by 11:59 p.m. on Oct-01-2026, to avoid cancellation
penalty equal to the first night's room and tax.
When you check in, a hold may be placed on your card for the full anticipated amount to
be owed to the hotel, including estimated incidentals, through your date of check-out. Any
such hold may not be released for 72 hours from the date of check-out or longer at the
discretion of your card issuer.
If the slider is used to select a Points and Money combination, that selection is final once
your stay is booked.
Important updates
Destlnaton dining
Enjoy global flavors at our
onsite dining, or keep meals
easy with room service.
Your Stay
Brand Highlights:
Meetings & events
Host meetings and events in
flexible spaces designed for
connection and comfort.
Fitness center
Keep your routine with guided
workouts, Peloton bikes, and
spaces for strength work.
Thank you for booking directly with Hilton.
x
Hilton Honors Benefits:
Elite status benefits are subject to availability and vary by brand and by individual property, In -Room Internet Access, Fitness
Center/Health Club Access and Bottled Water benefits may not be complimentary at properties with a resort charge. Space -available
upgrades only available at select brands. For more information, please visit Hilton Honors.com/e n.
Please do not reply to this email, as mail sent to this address cannot be answered.
If you have questions please visit our Help Center page and select the applicable contact method.
Hilton Honors membership and redemption of Points are subject to Hilton Honors Terms and Conditions.
This email advertisement was delivered to rfikeCagrantcountywa.gov. Ursubscribing from all marketing email will prevent you from
receiving your Hilton Honors Nlonthly Statement. You can continue to check your account by logging into your profile, contacting by phone
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Privacy Policy
Hilton Reservations and Customer Care
7930 Jones Branch Drive
McLean, Virginia 22102. USA
2026-07-13-EM-Trigger-1 089-Reservaltl'on-Confirmation-PROD-204'-"306-EN
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Departing flights
How our sort order and personalized savings work Cj)
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Spokane (GEG) - Atlanta (ATL)
Alaska Airlines operated by ALASKA
Nt
12.-38pm 8: 01 p m
Spokane (GEG) - Atlanta (ATL)
Delta
7h 28m,* I stop
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4h 23m * Nonstop
Z-1
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Roundtrip per traveler
4h 14m * Nonstop
10:50pm 6:04am
Spokane (GEG) - Atlanta (ATL)
Delta
Bundle& Save deal "book,"tis lligh, wfth select staayour Igwl o-.-1 r i gh
tdIy-d 7h 28m -* 1 stop
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5:04am -*- 3,-32pm
Spokane (GEG) - Atlanta 'ATL)
Alaska Airlines
0
7-1,43pm -&*- 7:30am+l
Spokane (GEG) - Atlanta (ATL)
Alaska Airlines operated by ALASKA
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6:00am --o- 5,-07pm
Spokane (GEG) - Atlanta (ATL)
Alaska Airlines operated by ALASKA
6:00am -*- 4:38pm
Spokane (GEG) - Atlanta (ATL)
American Airlines
NOW
7:Lei 0pm -*- 6:40irk m,
Spokane (GEG) - Atlanta (ATL)
Southwest Airlines
8h 47m a 1 stop
2h 43m in SEA
8h 7m * I stop
Ih 50m in SEA
7h 38me I stop
Ih 49m in DFW
8h 10m * 1 stop
2h 10m in 'AS
I
$528
Roundtrip per traveler
FlIgII)t det-ads
$399
Roundtrip per traveler
$478
Roundtrip per traveler
$538
Rouncitrip per traveler
$402
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6:25am -*- 3:35pm
Spokane (GEG) - Atlanta (ATL)
Southwest Airlines
6-.20dam -*- 6:30am'
Spokane (GE) - Atlanta (ATL)
Southwest Airlines
a
12:44pm -po,- 11:59pm
Spokane (GEG) - Atlanta (ATL)
Alaska Airlines operated by ALASKA
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1-.49pm -*- II.-59pm
Spokane (GEC ) - Atlanta (ATL)
Alaska Airlines operated by ALAS
A 'Okmir"
2:35pm -*-- 11:36pm
Spokane (GEG) - Atlanta (ATQ
Delta
5:00am --a- 3:19pm
Spokane (GEG) - Atlanta (ATL)
United
6h 10m * I stop
Ih in DEN
9h 10m -, 1 stop
3h 10m in PHX
8h 15m * 1 stop
2h 3m in SEA
7h 10m * I stop
58m in SEA
6h 1m * I stop
40m in MSP
7h 19m * 1 stop
Ih 52m in DEN
d
$578
Roundtrip per traveler
Flight det,---ills
$402
Roundtrip per traveler
$439
Roundthp per traveler
'-dietpi
$478
Roundtrip per traveler
$558
Roundtrip per traveler
$588
Roundtrip per traveler
5:20am —*— 34*,42pm
Spokane (GEG) - Atlanta (ATL)
Delta
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2:50pm —o--- 11:35pm
Spokane (GEG) - Atlanta (ATL)
Southwest Airlines
1-25pm 11:39R�✓ pm
Spokane (GE) - Atlanta (ATL)
Delta
7:06pm
Spokane (GEG) - Atlanta (ATL)
Delta
4:38pm —o— 7-030am'
Spokane (GEG) - Atlanta (ATL)
Alaska Airlines operated by ALASKA
12:45pm 11:47pm
Spokane (GEG) - Atlanta (ATL)
American Airlines
7h 22m * I stop
Ih 58m in SLC
5h 45m # 1 stop
50m in DEN
7h 14m * 1 stop
1h 44m in ".-,LC
7h 9m # I stop
Ih 43m in SLC
11h 52m * 1 stop
Sh 48m in SEA
8h 2m a I stop
2h 7m in DFW
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Rouncitrip per traveler
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tglht. deft -ails
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6:00am 6:26pm
Spokane (GEG) - Atlanta (ATQ
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EXPRESS and United
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9h 43m * 1 stop $538
9—h 37m in LAX Roundtrip per traveler
4:19pm —*— 5:02am
Spokane (GEG) - Atlanta (ATL)
Delta operated by SKY EST IBA DELTA
CONNECTION and Delta
13h 45m * 2 stops $468
6h 10m in PHX # 35m in AUS Rouncitrip per traveler
5:25am 10,010pm
Spokane (GEG) - Atlanta (ATL)
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13h 39m * I stop
rem, $483
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7:20aIre —o-- 11:59pm
Spokane (GEG) - Atlanta {ATE.}
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. ......... ...... ------
Thu, Oct I Fri, Oct 2 Sat, Oct 3 Sun, Oct 4 can, Oct 5 Tue, Oct 6 Wed, Oct 7
$366 $350 $288 $358 $334 $301 $361
Departing flights
How our sort order and personalized savings work Q
9:10 am 5* -07 pm
4h 57m * Nonstop
4 5 2
Roundtrip per traveler
Seattle (SEA) - Atlanta (ATL)
Alaska Airlines operated by ALASKA
details
4h 43m * Nonstop $487
Roundtrip per traveler
6*00am - 1:43pm
Seattle,(SEA) - Atlanta (ATQ
Delta
Flia,ht cjet�ids
4h 47m # Nons.-Aop $437
Rouncitrip per traveler
11:43pm 7:30ami"
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A.
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Alaska Airlines
4h 55m # Nonstop $37
Roundtrip per traveler
4:04pm - 11:59pm
Seattle (SEA) - Atlanta (ATQ
Alaska Airlines operated by ALASKA
4h 34m Nons;top $627
Rouncitrip per traveler
9:00am 4:34pm
Seattle (SEA) - Atlanta (ATL)
Delta
d
4h 43m * Nonstop $587
Roundtrip per traveler
7:20am - 3-,,03pm
Seattle (SEA) - Atlanta (ATL)
Delta
FIV-A details
4h 36m Nonstop $487
Roundtrip per traveler
11-459pm 7:35am
Seattle (SEA) - Atlanta (ATL)
Delta
F1 io ht det'a I Its
4h 49m * Nonstop $687
Rouncitrip per traveler
11:35am — 7-.24pm
Seattle (SEA) - Atlanta (ATQ
Delta
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light t dea,1H
7h 25mp I stop
$447
V 51m in CLT Roundtrip per traveler
7:15am 5*40pm
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American Airlines operated by American Airlines
and PSA AIRLINES AS AMERICAN EAGLE
El{t 'd, Mails
A 4h 36m * Nonstop $587
'wkst.... Rouncitrip per traveler
10-,59pm — 6:35am"'!
Seattle (SEA) - Atlanta (ATQ
Delta
1 Fl (L-
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6h 54m # I stop
$447
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5:30am —*— 3:24pm
Seattle (SEA) - Atlanta (ATL)
American Airlines
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7h 19m * 1 stop $447
V 49m in CLT Rouncitrip per traveler
5:00am —*— 3:19pm
Seattle (SEA) - Atlanta (ATQ
American Airlines operated by American Airlines
and PSA AIRLINES AS AI ERICAN EAGLE
Pl ght detads
7h 35m I stop $417
1h5Om in MDW Roundtrip per traveler
Seattle (SEA) - Atlanta (ATQ
Southwest Airlines
Hight detalls
7h 27m * 1 stop $447
1h 3m in DFW Rouncitrip per traveler
10.-,17am --a-- 8:44pm
Seattle (SEA) - Atlanta (ATQ
American Airline-,
--
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8h 8m * I stop $447
1h 57m in DFW Rouncitrip per traveler
5:30am 4:38pm
Seattle (SEA) - Atlanta (ATQ
American Airlines
F I
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8h 10m * 1 stop $417
2h 25m in MDW ROLAndtrip per traveler
12:10am -*- 11:20am
Seattle (SEA) - Atlanta (ATQ
Southwest Airlines
Am h m 1244# I stop
am $358
AV 6h 56m in DEN Rouncitrip per traveler
7:41pm 11.25am
Seattle (SEA) - Atlanta (ATQ
Frontier Airlines
F lh g de It ai
7h 25m -P 1 stop $447
1h 17m in DFW Roundtrip per traveler
11:59pm 1
Seattle (SEA) - Atlanta (ATQ
American Airlines
Flig' f details
7h 20m o I stop $417
1h 5m in LAS Roundtrip per traveler
8:20PM --9- 6,-40amil
Seattle (SEA) - Atlanta (ATQ
Southwest Airlines
FlIgInt. Cie-il-ails
8h io I stop $417
1h 45m in AUS Roundtrip per traveler
11:10am --e- 10:10pm
Seattle (SEA) - Atlanta (AI-)
Southwest Airlines
7h 50m * 1 stop $447
1h 15m in CLT Roundtrip per traveler
11:0tie am -*- 9-.52pm
Seattle (SEA) - Atlanta (ATE.).
American Airlines operated by American Airlines
and PSA AIRLINES AS AlRICAN EAGLE
Fliht detail o,s
8h 30m * I stop
$447
2h 20m in DE W Roundtrip per traveler
7,-51am T:21pm
Seattle (SEA) - Atlanta (ATL)
Amerilcan Airlines
t
yf 7h 2m * 1 stop $484
49m in ORD Roundtrip per traveler
11:57PM --V- 9:59am
Seattle (SEA) - Atlanta (ATQ
American Airlines
t
7h 45m * 1 stop $447
1h 7m in CLT Rouncitrip per traveler
1:11pm —o-- 11:56pm
Seattle (SEA) - Atlanta (ATQ
American Airlines operated by American Airlines
and PSA AIRLINES AS AMERICAN EAGLE
F11oh-t details
8h 12m * 1 stop $484
1h 35m in ORD Roundtrip per traveler
10:59am —*— 101:11pm
Seattle (SEA) - Atlanta {ATE.}
American Airlines
F I i r--j h t ci P; t a i Is
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11-i"st �.i r pro -
Training Travel Request
In -State Training Out -of State Training
(Must be received 30 days in advance) (Must be received 90 days is advance)
Employee Name:*
Isidro G. Alvarez
Employee Email*
ic,alvarez@grantcountywa.gov
Training Name-*
crisiscon
Who will be registering you?*
I am already registered.
I will register myself prior to event.
Finance department will register me.
Copy and Paste Registration link here:
If no digital registration, scan and drop flyer here.
Today's Date:
06/1512026
Location:*
Atlanta Georgia
Drag and drop Up to 10 files here to upload or
Registration Cost:*
850.00
Will you be traveling for this training?
- Yes
No
Start of training
10/0512026 08:00 PM G
Travel Info
Departing Date:
10/0412026 08:00 AM 01
Hotel: *
Yes No
Transportation:
Personal Car Company Car Not Applicable
(if requesting to take personal car, direct supervisor signature is required below)
Airfare:
Yes
No
renewaK--WZ -*A)i*JA 'i Wc��Wls
Webinar
jt" 0 8 2026
End of training:
10/08/2026 0 5: 0 0 A N1 01-
lh4
Returning Date:
10/09/2026 hh:rnm A
Are there any room blocks for this training at a specific hotel?
none
1/2
How will this training add value to the organization?*
This training will benefit clinician by adding knowledge during de escalation situations
Manager/Supervisor
Manager/Supervisor E-mail*
jmuck@grantcountywa.gov
Estimated Cost:
Training Approved:
Yes No
Direct Supervisor Signature:
t
0,70mar-h alo
TO BE COMPLETED BY DIRECT SUPERVISOR
Funding Source:
Date: *
06/16/2026
Date: *
06/16/2026 tj
Does this need to go to Manager before approval?
Yes, to Manager prior to ELTI
No, To ELT directly
ELT approved, send to finance directly
Director to send to for approval:
Juan Padilla
TO BE COMPLETED BY EXECUTIVE STAFF
Executive Staff Approval:*
Yes No
Executive Staff Signature:* Date:
06/17/2026
2/2