BA 645 TrainingForm

BA 645 TrainingForm - A. Agency, code agency subelement and...

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AUTHORIZATION, AGREEMENT AND CERTIFICATION OF TRAINING A. Agency, code agency subelement and submitting office number B. Request Status (Mark (X) one) Resubmission Initial Cancellation Correction Section A - TRAINEE INFORMATION Please read instructions on page 6 before completing this form 1. Applicant's Name ( Last, First, Middle Initial) 2. Social Security Number/Federal Employee Number 3. Date of birth (yyyy-mm-dd) 4. Home Address (Number, Street, City, State, ZIP Code) (Optional) 5. Home Telephone (Optional) (Include Area Code) 6. Position Level (Mark (X) one) a. Non-supervisory b. Manager c. Supervisory d. Executive 7. Organization Mailing Address (Branch-Division/Office/Bureau/Agency) 8. Office Telephone (Include Area Code and extension) 9. Work Email Address 10. Position Title. 11. Does applicant need special accommodation? Yes No If yes, please describe below 12. Type of Appointment 13. Education Level (click link to view codes or go to page 7) 14. Pay Plan 15. Series 16. Grade 17. Step Section B - TRAINING COURSE DATA 1a. Name and Mailing Address of Training Vendor (No., Street, City, State, ZIP Code) 1b. Location of Training Site (if same, mark box) 1c. Vendor Telephone Number 1d. Vendor Email Address 2a. Course Title 2b. Course Number Code 3. Training Start Date (Enter date as yyyy-mm-dd) 4. Training End Date (Enter date as yyyy-mm-dd) 5. Training Duty Hours 6. Training Non-Duty Hours 7. Training Purpose Type (click link to view codes or go to page 9) 8. Training Type Code (click link to view codes or go to pages 10-12) 9. Training Sub Type Code (click link to view codes or go to pages 10-12) 10. Training Delivery Type Code (click link to view codes or go to page 12) 11. Training Designation Type Code (click link to view codes or go to page 13) 12. Training Credit 13. Training Credit Type Code (click link to view codes or go to page 13) 14. Training Accreditation Indicator (Check below) Yes No 15. Continued Service Agreement Required Indicator (Check below) Yes No N/A 16. Continuing Service Agreement Expiration Date (Enter date as yyyy-mm-dd) 17. Training Source Type Code (click link to view codes or go to page 13) 18. Training Objective 19. AGENCY USE ONLY Section C - COSTS AND BILLING INFORMATION 1. Direct Costs and Appropriation/Fund Chargeable Item Amount Appropriation Fund a. Tuition and Fees b. Books and Materials c. TOTAL Appropriation Fund Amount Item 2. Indirect Costs and Appropriation/Fund Chargeable c. TOTAL b. Per Diem a. Travel 3. Total Training Non-Government Contribution Cost 4. Document/Purchasing Order/Requisition Number 5. 8-Digit Station Symbol (Example - 12-34-5678) 6. BILLING INSTRUCTIONS (Furnish invoice to) : U.S. Office of Personnel Management Page 1 NSN 7540-01-008-3901 Standard Form 182 Revised December 2006 All previous editions not usable. For DoD Use Only
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This note was uploaded on 11/07/2011 for the course BA 645 taught by Professor Dr.morvey during the Summer '11 term at Ohio State.

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BA 645 TrainingForm - A. Agency, code agency subelement and...

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