Pipeline Training Request Form

Core Value #5: Pursue Growth and Learning!
All forms must be returned at least 3 days prior to the start date of the class/training you have chosen.
While you may not get chosen for each and every class, we will do our best to get everyone into the training of their
choice while working closely with your Manager to determine the best time for you to attend.

Name:________________________________________________________________________
E-mail address:_______________________________________________ Do you check e-mail __Yes __No
Manager:____________________________ Shift/Department:_________________________

*One form per class please!
Life of an LPN:

Tuesday, March 22 3–5 PM
Thursday, March 24 3–5 PM

Tuesday, March 22 6:30–8:30 PM
Wednesday, March 30 6:30–8:30 PM

Intro to
Microsoft Word:

Wednesday, March 2 9-11 AM
Thursday, March 10 3-5 PM

Tuesday, March 8 6:30-8:30 PM
Thursday, March 10 6:30–8:30 PM

Zappos History:

Tuesday, March 22 9-11 AM
Wednesday, March 23 6:30-8:30 PM

Wednesday, March 23 3-5 PM
Tuesday, March 29 6:30–8:30 PM

Tell us in 25-50 words why you would like to attend the class/training:
*Please note that your awesome essay may be published in future publications.

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Managers: By signing below, you agree that your team member can get their learn on during the times indicated
above. Woot! Woot!
Manager’s Approval:____________________________________________________________Date________________

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