State In-Service Seat Request

Please complete the following form to request a seat in an In-Service Training course.

UConn Health Seat Request Deadline ‐‐‐‐‐‐‐‐‐‐08/31/2020

Name*
First Last
Email*
Phone Number*
In case you need to be notified off work hours, please indicate an alternate number.
Payment*
For transfer voucher payments email hrregistration@uchc.edu for credit foapl and credit approver information. Personal checks must be submitted in person to Human Resources.
Course Selection*
In-Service Training Registration Agreement
I certify I have discussed my application for State In-Service training with my supervisor. I further certify my supervisor has approved my request prior to this application, including the use of department funds (if applicable) to pay for the course and how to account for time away from work to attend the course.
In-Service Training Registration Agreement*
- Yes
Supervisor's Name*
First Last
Supervisor Notification
Your supervisor will be notified of your request. You must speak with your supervisor to confirm use of department funds for payment, as well as accounting for time away from work to attend the course.
Supervisor's Email*
Enter Email Confirm Email

In-Service Training Registration Agreement