PRELIMINARY INFORMATION NEEDED FROM EMPLOYER

Employer

Number of employees receiving training

Type or title of training

Date of training

Total cost of training

Training location

Any additional costs related

to training (rent, software,

supplies, etc.)

Training Provider

Employer Contact Name

Contact’s Phone Number

Today’s Date

Employer Signature:

**This form is void 6 months from date received**

PLEASE COMPLETE THIS FORM AND MAIL WITH

EMPLOYEE SURVEYS TO:

Kathy Palmer

Fox Valley Workforce Development Board

996 S. Green Bay Road

Neenah, WI 54956