UCLA CHR Organizational Improvement and Staff Development

Enrollment Application - On-Line Courses

Please use this application if you are applying for any of the following on-line policy and procedure classes: PAC for Preparers, PAC for Reviewers, PAC update, Transfer of Funds, PPS Inquiry Functions, EDB for Preparers, EDB for Reviewers, PTR for Preparers, PTR for Reviewers, Fellowship Awards.

Course Name:
Course Number:	Begin Date:
Name (Printed):	Employee #:
Department:	Extension:
Campus Address:	Mail Code:
E-mail Address:	Fax:
Course Fee:	Method of Payment*:
Supervisor's E-mail:
Your Signature:
Signature of Supervisor or Budget Officer (Required):
Printed Name of Authorized Signature Above:

*Payment made by check or department recharge. If payment is Departmental recharge, please include FAU.

AIS Logon ID (Provide number):

Please check the boxes that identify your job duties

I am a preparer for: PACEDBPTR

I am a reviewer for: PACEDBPTR

I supervise preparers for: PACEDBPTR

I supervise reviewers for: PACEDBPTR

I am responsible for on-line transactions for: Academic
Academic Apprentice
Staff

Include department FAU number in "Method of Payment" box if paying by department recharge.
Checks should be given to the instructor on the first day of class.
DO NOT send checks or CASH to UCLA Organizational Improvement and Staff Development.

Return completed application to:

Organizational Improvement and Staff Development
10920 Wilshire Boulevard, Suite 200
Campus Mail Code 146548

Spring 2000 Training and Development Catalog Table of Contents

Organizational Improvement and Staff Development Home Page

UCLA Campus Human Resources
Organizational Improvement and Staff Development
310.794.0850

March 2000

AIS Logon ID (Provide number):
Please check the boxes that identify your job duties
I am a preparer for:	PACEDBPTR
I am a reviewer for:	PACEDBPTR
I supervise preparers for:	PACEDBPTR
I supervise reviewers for:	PACEDBPTR
I am responsible for on-line transactions for:	Academic Academic Apprentice Staff