Standard Form 182 – Fill Out and Use This PDF

Privacy Act Statement

Authority ─ This information is being collected under the authority of 5 U.S.C. § 4115, a provision of The Government Employees Training Act.

Purposes and Uses ─ The primary purpose of the information collected is for use in the administration of the Federal Training Program (FTP) to document the nomination of trainees and completion of training. Information collected may also be provided to other agencies and to Congress upon request. This information becomes a part of the permanent employment record of participants in training programs, and should be included in the Governmentwide electronic system, (the Enterprise Human Resource Integration system (EHRI) and is subject to all of the published routine uses of that system of records.

Effects and Nondisclosure ─ Providing the personal information requested is voluntary; however, failure to provide this information may result in ineligibility for participation in training programs or errors in the processing of training you have applied for or completed.

Information Regarding Disclosure of your Social Security Number (SSN) Under Public Law 93-579, Section 7(b) ─ Solicitation of SSNs by the Office of Personnel Management (OPM) is authorized under provisions of the Executive Order 9397, dated November 22, 1943. Your SSN will be used primarily to give you recognition for completing the training and to accumulate Governmentwide training statistical data and information. SSNs also will be used for the selection of persons to be included in statistical studies of training management matters. The use of SSNs is necessary because of the large number of current Federal employees who have identical names and/or birth dates and whose identities can only be distinguished by their SSNs.

Note: This agreement must be signed by the nominee for Government training that exceeds 80 hours (or such other designated period, less than 80 hours as prescribed by the agency) for which the Government approves payment of training costs prior to the commencement of such training. Nothing contained in this SAMPLE agreement below shall be construed as limiting the authority of an agency to waive, in whole or in part, an obligation of an employee to pay expenses incurred by the Government in connection with the training.

Continued Service Agreement

Employees, who are selected to training for more than a minimum period as prescribed in Title 5 USC 4108 and 5 CFR 410.309, see your supervisor for more information on the internal policies to implement a continued service agreement.

Employees Agreement to Continue in Service

To be completed by applicant:

1.I AGREE that, upon completion of the Government sponsored training described in this authorization, if I receive salary covering the training period, I will serve in the agency three (3) times the length of the training period. If I received no salary during the training period, I agree to serve the agency for a period equal to the length of training, but in no case less than one month. (The length of part-time training is the number of hours spent in class or with the instructor. The length of full-time training is eight hours for each day of training, up to a maximum of 40 hours a week).

NOTE: For the purposes of this agreement the term “agency” refers to the employing organization (such as an Executive Department or Independent Establishment), not to a segment of such organization.

2.If I voluntarily leave the agency before completing the period of service agreed to in item 1 above, I AGREE to reimburse the agency for fees, such as the tuition and related fees, travel, and other special expenses (EXCLUDING SALARY) paid in connection with my training. These fees are reflected in Section C Costs and Billing Information. Note: Additional information about fees and expenses can be found in the Guide to Human Resource Reporting (GHRR). http://www.opm.gov/feddata/ghrr/index.asp

3.I FURTHER AGREE that, if I voluntarily leave the agency to enter the service of another Federal agency or other organization in any branch of the Government before completing the period of service agreed, I will give my organization written notice of at least ten working days during which time a determination concerning reimbursement will be made. If I fail to give this advance notice, I AGREE to pay the full amount of additional expenses 5 U.S.C. 4108 (a) (2) incurred by the Government in this training.

4.I understand that any amount of money which may be due to the agency as a result of any failure on my part to meet the terms of this agreement may be withheld from any monies owed me by the Government, or may be recovered by such other methods as are approved by law.

5.I FURTHER AGREE to obtain approval from my organization and the person responsible for authorizing government training requests of any proposed change in my approved training program involving course and schedule changes, withdrawals or incompletions, and increased costs.

6.I acknowledge that this agreement does not in any way commit the Government to continue my employment. I understand that if there is a transfer of my service obligation to another Federal agency or other organization in any branch of the Government, the agreements will remain in effect until I have completed my obligated service with that other agency or organization.

Period of obligated Service: ______________________________________

Employee's Signature: __________________________________________

Date: __________________

Agency Training Electronic Reporting Instructions

General Instructions:

1.You must complete all questions in sections A-E on the training application. In addition, your financial institution must complete Section F Certification of Training Completion and Evaluation section.

2.Electronic Requirements - An agency should only submit data for completed training that is defined as a training event for which the student has accomplished all components in the title of the event.

3.Collection of training data requires completed training events and that all mandatory data elements have been recorded. Training may vary from agency to agency. This form provides conformity and standardization for the required core data.

4.Codes for underlined elements will link you to the chart. Identify the correct code, then return to the form (links will not automatically return you to the form).

Section A - Trainee Information

1.Applicant's Name - Last Name, First Name, Middle Initial.

2. Social Security Number - Use employee's nine (9) digit SSN. (123-45-6789)

OR

Federal Employee Number -The unique number that Enterprise Human Resources Integration (EHRI) will assign to an employee to identify employee records within the EHRI system. (Agency)

3.Date of Birth (format yyyy-mm-dd) - Employee's date of birth (e.g. if employee's birth date is March 25, 1951, it would appear as (1951-03-25).

4.Home Address - Employee's home address, include the street number, city, state, and zip code.

5.Home Telephone Number - Employee's area code, home telephone number.

6.Position Level - Select whether the employee's position level is one of the following:

6a. Non supervisory - Anyone who does not have supervisory/team leader responsibilities.

6b. Supervisory - First line supervisors who do not supervise other supervisors; typically those who are responsible for an employee's performance appraisal or approval of their leave.

6c. Manager - Those in management positions who typically supervise one or more supervisors.

6d. Executive - Members of the Senior Executive Service (SES) or equivalent.

7.Organization Mailing Address - This is the internal agency address of the employee Branch-Division/Office/Bureau/Agency, include the street name, city, state and zip code.

8.Office Telephone Number - Insert the employee's area code, office telephone number and extension.

9.Work E-mail Address - Agency e-mail address.

10.Position Title - Employee's current position within the agency.

Section A - Trainee Information (Continued)

11.Does Applicant Need Special Accommodations? - Indicate "Yes" or "No". If the applicant is in need of special arrangements (brailing, taping, interpreters, facility accessibility, etc), describe the requirements in the space provided or on a separate sheet.

12.Type of Appointment - The employee type of appointment

(e.g., Career Conditional (CC), Career (C), Temporary (Temp.), Schedule A, etc.).

13. Education Level -Use the employee educational level codes listed below.

14. Pay Plan - The employee's pay plan. (e.g., GS, WG, ES…Pay Band)

15.Series - The position classification four digit series. (e.g., 0201)

16.Grade - The employee's grade level. (1-15)

17.Step - The employee must insert the appropriate step. (1-10)

Section B - Training Course Data

1a. Name and Mailing Address of Training Vendor - Street number, city, state, and ZIP code of the appropriate vendor. (Agency specific)

1b. Location of the Training Site - Provide mailing address of the training site if different from 1a. (Agency specific)

1c. Vendor Telephone Number - Self explanatory. (Agency specific)

1d. Vendor E-mail Address - Self explanatory. (Agency specific)

2a. Course Title - Insert the title of the course or the program that the employee is scheduled to complete. 2b. Course Number Code - Insert the Course Number Code.

3.Training Start Date - Insert the start date of the training completed by the employee. (yyyy-mm-dd)

4.Training End Date - Insert the end date of the training completed by the employee. (yyyy-mm-dd)

5.Training Duty Hours - Insert the number of duty hours for training.

6.Training Non Duty Hours -Insert the number of non-duty hours for training.

7.Training Purpose Type - Insert the purpose for taking this course or program using the appropriate training purpose type code.

8.Training Type Code - There are three (3) different Training Type Codes. The employee must select one from the Training Type Codes. (Select from the chart on pages 10-12 .)

9.Training Sub-Type Code - There are Sub-Type Categories for each of the three (3) different Training Type Codes. Select one (1) Sub-Type Category code that applies to the training type code you selected. (Select from the chart on pages 10-12.)

Section B - Training Course Data (Continued)

Section B - Training Course Data (Continued)

Section B - Training Course Data (Continued)

10.Training Delivery Type Code --

Section B - Training Course Data (Continued)

11.Training Designation Type Code - Select and insert the appropriate training credit designation type code:

12.Training Credit - Amount of academic credit hours of continued education units (1, 1.5, or .75) earned by the employee for the completed training. (This should be completed by the agency).

13.Training Credit Type Code - Select and insert the appropriate training credit designation type code:

01Semester Hours

02Quarter Hours

03Continuing Education Unit

14.Training Accreditation Indicator - Insert a Yes (Y) or No (N).

15.Continued Service Agreement Required Indicator - Insert Yes (Y) or No (N) or non applicable (N/A) in appropriate space. (Agency response.)

16.Continued Service Agreement Expiration Date - (Enter date as yyyy-mm-dd).

17.Training Source Type Code --

18.Training Objectives - It is important that the objectives for the employee(s) enrolling in this course or program is related to the strategic objectives of the organization for which the employee works. Provide text to explain how the training event meets agency objective(s) and purpose type.

19.Agency Use Only -For use by an agency as needed.

Section C - Costs and Billing Information

1.Direct costs and appropriation/fund chargeable

a.Training Tuition and Fees Cost - Insert the actual/final cost of training tuition and fees for training completed by the employee that was paid for by the Federal Government.

b.Books and Materials Costs - Insert the materials cost for training completed by the employee that was paid for by the Federal Government. (Refer to the Guide for Human Resources Reporting Guide at http://www.opm. gov/feddata/guidance.asp for more information).

c. Total Cost - Insert the actual/final cost.

2.Indirect costs and appropriation/fund chargeable

a.Training Travel Cost - Insert the actual/final travel cost excluding per diem for training completed by the employee that was paid for by the Federal Government.

b.Training Per Diem Cost - Insert the actual/final per diem cost (e.g., meals, lodging, miscellaneous expenses) for training completed by the employee that was paid for by the Federal Government.

c.Total Cost - Insert the actual/final cost.

3.Total Training Non-Government Contribution Cost - Insert the cost contributed by the employee or other non- Government organizations for the training completed by the employee.

4.Document/Purchase Order/Requisition Number - Enter Document/Purchase Order/Requisition Number for reimbursement of training costs to responsible Training Vendor. This number is to be referenced in the billing process.

5.8-Digit Station Symbol - Fill in 8-digit station symbol of the nominating Agency Finance Office.

6.Billing Instructions - Enter name and mailing address of nominating Agency Finance Office for billing purposes.

Section D - Approvals

1-3e. Approvals - To be completed by the employee's immediate and/or second-line supervisor(s) before submission of application to nomination Agency Training Office.

Section E - Approvals/Concurrence

1-1e. Approval/Concurrence - To be completed by the nominating Agency Official who is authorized to approve or disapprove request.

Section F - Certification of Training Completion and Evaluation

NOTE: Agency Certifying Officials are certifying the employee has completed the requirements for the training and an evaluation has been completed. The requirement to evaluate training is found in 5 CFR 410.601. The agency head shall evaluate training to determine how well it meets short and long-range program needs of the agency and the individual. The needs should be aligned with the strategic plan to strengthen and develop the performance and behavior of the individual whose positive results will impact the performance of the agency.