Class/training - Verification Form
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1
2CLASS / TRAINING SCHEDULE VERIFICATION
THE SHADED AREAS MUST BE COMPLETED BY AN AUTHORIZED REPRESENTATIVE OF THE
EDUCATIONAL/TRAINING INSTITUTE ONLY
Name of the Educational/Training Institution:
The Educational/Training Institution is accredited by:
Student course of study or major:
First day of enrollment:
First day of enrollment for the current semester/year:
Last day of enrollment for the current semester/year:
Anticipated completion/graduation date:
Current Schedule of Classes/Training:
If class/training schedule is consistent, complete Week One only.
If class/training schedule varies, complete all four weeks.
WEEK ONE:
WEEK TWO:
Date:
Date:
Monday
from
AM/PM to
AM/PM
Monday
from
AM/PM to
AM/PM
Tuesday
from
AM/PM to
AM/PM
Tuesday
from
AM/PM to
AM/PM
Wednesday
from
AM/PM to
AM/PM
Wednesday
from
AM/PM to
AM/PM
Thursday
from
AM/PM to
AM/PM
Thursday
from
AM/PM to
AM/PM
Friday
from
AM/PM to
AM/PM
Friday
from
AM/PM to
AM/PM
Saturday
from
AM/PM to
AM/PM
Saturday
from
AM/PM to
AM/PM
Sunday
from
AM/PM to
AM/PM
Sunday
from
AM/PM to
AM/PM
TOTAL NUMBER OF HOURS, WEEK ONE:
TOTAL NUMBER OF HOURS, WEEK TWO:
WEEK THREE:
WEEK FOUR:
Date:
Date:
Monday
from
AM/PM to
AM/PM
Monday
from
AM/PM to
AM/PM
Tuesday
from
AM/PM to
AM/PM
Tuesday
from
AM/PM to
AM/PM
Wednesday
from
AM/PM to
AM/PM
Wednesday
from
AM/PM to
AM/PM
Thursday
from
AM/PM to
AM/PM
Thursday
from
AM/PM to
AM/PM
Friday
from
AM/PM to
AM/PM
Friday
from
AM/PM to
AM/PM
Saturday
from
AM/PM to
AM/PM
Saturday
from
AM/PM to
AM/PM
Sunday
from
AM/PM to
AM/PM
Sunday
from
AM/PM to
AM/PM
TOTAL NUMBER OF HOURS, WEEK THREE:
TOTAL NUMBER OF HOURS, WEEK FOUR:
SCHOOL SEAL OR STAMP:
CD 930 12/07
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