Employee name

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Officer number

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Today's date

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mm/dd/yyyy

Training course title

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Date leaving for training

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mm/dd/yyyy

Time leaving for training

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hour : minute

Training start date

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mm/dd/yyyy

Training End date

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mm/dd/yyyy

Date returning from training

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mm/dd/yyyy

Training Location

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Total training hours

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Sponsor

Registration cost

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Per Diem total

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Please calculate your total Per Diem rate and then describe Per Diem in comments

Will lodging be required?

Yes

No

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If yes, how many nights?

Dates for loding?

List dates needed for lodging for the training.

Comments

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Supervisor's name

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