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Training Reimbursement Form

Name: *
Date: *
Class Title: *
Dates of Class Taken: *
Instructor(s):
Location of class: *
Total cost of class: *
Amount requested: *
I have read the Guidelines of Reimbursement (available on Training/Safety page): *
Certificates of completion sent to TRAINING@WCFIRE.COM? *
I certify the information above, have read and agree to the Guidelines of Reimbursement: *
E-signature (Print Name): *
Date: *
Training Division Approval:
Chief's Office Approval:
Treasurer Approval:
Disapproval:
Disapproval Reason(s):