Study and Training Request Form

All fields are REQUIRED!

1. Requester Information
First Name
Last Name
Title
Mailing Address
City
State	AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA WA DC WV WI WY
Zip Code
Phone Number
Email Address
Supervisor's Name
Supervisor's Email
Supervisor's Phone Number
2. Type of Study or Training Requested	Part-time Study  Professional Development through Graduate Study (formerly known as Study Leave) http://extensionlearning.tamu.edu/PDFs/GuidelinesforTakingCourses2008.pdf
Once completed, this request will be forwarded to your supervisor, extension education, associate department head/assistant director, and director for approval. You do NOT need to mail in this form.

If you have questions about about making a study and training request, please contact Organizational Development: 979-845-7210.
If you experience any errors while using this form, please email Summer S. Wilson.