Standard Form 182 - Authorization, Agreement And Certification Of Training
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14B. Request Status (Mark (X) one)
A. Agency, code agency subelement
AUTHORIZATION, AGREEMENT
and submitting office number
Resubmission
Initial
AND CERTIFICATION OF TRAINING
Correction
Cancellation
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)
6. Position Level (Mark (X) one)
4. Home Address (Number, Street, City, State, ZIP Code) (Optional)
5.
Home Telephone (Optional)
(Include Area Code)
a. Non-supervisory
b. Manager
c. Supervisory
d. Executive
7. Organization Mailing Address (Branch-Division/Office/Bureau/Agency))
8.
OfficeTelephone
9. Work Email Address
(Include Area Code and Extension)
11. Does applicant need special
10. Position Title
If yes, please describe below
accomodation?
Yes
No
12. Type of Appointment
14. Pay Plan
15. Series
16. Grade
17. Step
13.
Education Level
(click link to view codes or go to page 7)
Section B - TRAINING COURSE DATA
1b. Location of Training Site (if same, mark box)
1a. Name and Mailing Address of Training Vendor (No., Street, City, State, ZIP Code)
Ft. McNair monthly and Virginia Beach, VA for Annual Institute
2025 M St. NW
Suite 800
1c. Vendor Telephone Number
1d. Vendor Email Address
202-973-8683
Washington D.C. 20036
2a. Course Title
2b. Course Number Code
3. Training Start Date
4. Training End Date (Enter Date as yyyy-mm-d
(Enter Date as yyyy-mm-dd)
d)
2017-09-12
2018-06-12
7.
Training Purpose Type
5. Training Duty Hours
6. Training Non-Duty Hours
8.
Training Type Code
(Click link to view codes or go to page 9)
(Click link to view codes or go to page 9)
9.
Training Sub Type Code
10.
Training Delivery Type Code
11.
Training Designation Type Code
12. Training Credit
13.
Training Credit Type Code
(Click link to view codes or go to page 9)
(Click link to view codes or go to page 12)
(Click link to view codes or go to page 13)
(Click link to view codes or go to page 13)
14. Training Accreditation Indicator
15. Continued Service Agreement
16. Continued Service Agreement Expiration Date
17.
Training Source Type Code
(
Required Indicator
Check below)
(Check below)
(Enter date as yyyy-mm-dd)
(Click link to view codes or go to page 13)
Yes
No
Yes
No
N/A
18. Training Objective
19. AGENCY USE ONLY
Section C - COSTS AND BILLING INFORMATION
1. Direct Costs and Appropriation / Fund Chargeable
2. Indirect Costs and Appropriation / Fund Chargeable
Appropriation Fund
Appropriation Fund
Item
Amount
Amount
Item
a. Tuition and Fees
a. Travel
$
$
b. Books & Material Costs
b. Per Diem
$
$
c. TOTAL
c. TOTAL
$
$
6. BILLING INSTRUCTIONS (Furnish invoice to):
3. Total Training Non-Government Contribution Cost
4. Document / Purchasing Order / Requisition Number
5. 8 - Digit Station Symbol (Example - 12-34-5678)
U.S. Office of Personnel Management
Standard Form 182
Page 1
Revised December 2006
NSN 7540-01-008-3901
All previous editions not usable.
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Parent category: Business