Continuing Education Request Form

Please review the steps below to ensure reimbursement and CE approval.

1. Team members complete the top portion and submit the form to their manager at least 30 days before the requested time off.

2. Incomplete request forms will not be processed and returned to the team member for completion.

3. Your manager will notify the team member of approval status via email, ccing the finance and HR department.

4. Following completion of the conference, the team member will send a copy of the Certificate of Course Completion to your manager. Team members will also include a short informative report or video to the L&D department to add to the Partner LMS Platform.

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Your Manager *Christy SchwartzJulie CrosbyKatie BrooksChristine StaffordAmber MauKelly Cronin

Name *

First

Last

Conference *VVMA 2024ACVIM 2024AVMA ConventionIVECCS 2024VMX 2024Midwest Veterinary Conference (MVC)Western Veterinary Conference (WVC)Fetch dvm360Other

Name of Conference *

Date of Request *

Registration Cost *

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Conference Start Date *

Conference End Date *

Brief description of lectures that will be attended and learning objectives: *

*

• In the event I separate employment with Partner or move to Part-Time or Relief/W2 status prior to the CE event, and the event expenses were reimbursed, the amount of the CE expenses will be deducted from the final two paychecks.

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Signature *

*By typing your name above you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

Date / Time *

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