REQUEST FOR APPROVAL OF COURSE/WORKSHOP For workshop please note in the notes section

REIMBURSEMENT WILL NOT BE APPROVED IF REQUEST FOR APPROVAL IS NOT RECEIVED PRIOR TO TAKING THE COURSE

Date * +

Your Email Address *

Employee # *

Employee Name *

Your Full Home Address *

School *

Email Address of Principal/Administrator Approving the Course? *

Your Position *

Date Course Begins * +

Date Course Ends * +

Where course is to be taken *

Course Number *

Name of Course *

Name of Instructor

Credits *

Tuition Fee *

Please choose appropriate option *

Notes