UW-Extension - UW-Extension

UW-Extension Technology Training

Requester Information

First name:

Last name:

Division:

Department:

Phone number:

E-mail:

Group Information

Group size:

Skill level: End User Training Technical staff training

Class information

Name:

Provider

Date: (mm/dd/yyyy)

Location:

Duration:

Justification:

Cost information

Note: At least 25% of the total costs must be paid by the department.

Please do NOT enter "$" signs in the cost fields below (ie. 500.00 or just 500).

Course fee: $

Transportation: $

Lodging: $

Meals: $

Misc: $

Description of misc. costs:

Department head:

The signature of your department head is required for proposal approval. If you submit your proposal electronically, you may ignore the Signature line but the training committee may contact the department head to verify consent.

Signature: not required for electronic submission Date: August 28, 2008

University of Wisconsin - Extension

Learning for life

UW-Extension Technology Training