REQUEST FOR TRAINING



   Employee Name:                         Department:





  PART I

  I am applying for the following training under the Company's tuition reimbursement 
  program.  I understand that if approval is granted, I am responsible for achieving 
  a grade of at least "B" in order to be eligible for reimbursement.

  Name of Educational Institution:                                                                                 

  Course(s) Desired:                                                                                                   
                                                                                                                              

  Relationship of Course to Job (Benefits to Company Operations):                                              
                                                                                                                              
                                                                                                                              

  Date Course Begins:               Date Course Ends:                                 

  Estimated Cost:                 


  APPROVAL:

  Supervisor:                       Date:              



  PART II

  Submit this form upon completion of your program to your Supervisor along with copies of 
  paid receipts and grades completed.

  Costs To be Reimbursed:

  Grade(s)/Received:                      or Pass/Completed:                            

  Supervisor:                             Date: