NWCG INTERAGENCY TRAINING NOMINATION
AND
AGREEMENT TO COLLECT FUNDS

INSTRUCTIONS:  Complete Part I.  Complete Part II only if there are charges for the training.
	
PART I     TRAINING NOMINATION	
Course Name:	 	
	PRIORITY 		of			
		
Course Date(s)	Course Location	Course Tuition (if required)	
 	 		
Course Coordinator:
	Coordinator Phone: (Voice/Fax)
                	Coord. E-Mail:
	
Nominee's Name	Date Submitted	
 	 	
Working Job Title	E-mail Address     
            	
 	 Fax Number:       	
Agency (Name, Address)	Nominee's Mailing Address (if different) 	

		
Telephone No.		Telephone No.		
List training completed and dates pertinent to this course:	
	
List your past qualifications pertinent to this course: 	
	
Nominee's Signature: (I will notify the Unit Training Representative if I am unable to attend).	

Supervisor's Signature (I certify the nominee meets the prerequisites, or if not met I will put the reasons for attending the course in Remarks.)	

 Remarks:	

	
PMS Draft (9/99)                                                                                                                              NFES Draft	

Course Name: 					Nominee Name: 						

PART II     AGREEMENT TO COLLECT FUNDS (Complete only if there is a tuition charge.)

Please check the section appropriate to the legal authority to collect monies and complete the address/signature block.  This form must be signed by an individual with authority to sign agreements and obligate the funds listed.  Note:  Tribal governments are not covered by the Intergovernmental Cooperation Act of 1968.

               NON-FEDERAL AGENCIES:  Contractor, states, local governments engaged in fire suppression and protection of public lands.  This training, payment, and collection is duly authorized under the Intergovernmental Cooperation Act of 1968 as amended by the act of September 13, 1982 (P.L 97-258), Section 6505.  The NWCG Interagency Training Nomination constitutes written request and it is understood the bill for the training will consist of tuition plus all other identifiable costs as provided by law.  Authorizing signature is also certifying services requested cannot be procured reasonably and expeditiously through ordinary business channels and funds are available.  Provider's signature certifies the agency is offering similar services for its own use.
COMPLETE CHARGE CODE: (Include required fiscal references)  ______________________________________                                                                     

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               OTHER FEDERAL AGENCIES:  This training, payment, and collection is duly authorized under Section 601 of the Economy Act of June 30, 1932 (31 USC 1535) as amended.  The NWCG Interagency Training Nomination constitutes the required written request and it is understood the bill for the training will consist of tuition plus all other identifiable costs as provided by law.  Authorizing signatures is also certifying services requested are in the best interest of the United States; cannot be procured by contract as conveniently or cheaply from a commercial source and appropriate funds are available for this purpose.  Provider's signature certifies the agency is offering similar services for its own use.  
COMPLETE CHARGE CODE: (Include agency location)   		__________		_______			

                                             Agreement Number: 					________			
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                SAME AGENCY AS PROVIDER:  The NWCG Interagency Training Nomination constitutes agreement to pay charges as outlined in nomination materials.  Authorizing signature certifies funds are available for this purpose.
COMPLETE CHARGE CODE: (Include unit identifiers)  ______________________________________________                                                                                     

ADDRESS/SIGNATURE:

Billing address if different than Sponsor or Agency Address

 AUTHORIZED TO EXPEND FUNDS LISTED ABOVE:		    AGREES TO PROVIDE TRAINING REQUESTED:
  					                                         
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              Signature 	            Date                                     Signature 	               Date

		            					
                                  Title                                                                                             Title