Enclosure 1

FY2011 Nomination Format - R6

Continuing Education for
Natural Resource Professionals

Applicant Name:

Present Series/Grade:

Present Title:

Year started in Current Position:

Year started as Professional

Region/Forest:

District:

Address:

City/State/Zip Code:

Work Phone:

E-mail address:

Workshops completed in this Continuing Education Program (historical)

Workshop Title

Host Institution

Year

Workshops you are applying for in FY2011 - LIST IN PRIORITY ORDER.
For workshop descriptions, see the FY2011 brochure or CE-WFW Web site www.fs.fed.us/biology/education.

Workshop Title

Host Institution

Date

Forest Funds Available?

I fully support my employee to attend ONE of the above workshops requested (if more, please indicate below). This support includes time, travel and per diem.

______________________	_______________________	____________
Immediate Supervisor	Line Officer	Date

 If more than 1 approved, please note it below.

Initial the appropriate approval block, if applicable

1 more workshop (2 total)

2 more workshops (3 total)

3 more workshops (4 total)