Form SFN16933 "Continued Education Program Plan Annual Plan/Reimbursement" - North Dakota

What Is Form SFN16933?

This is a legal form that was released by the North Dakota Department of Career and Technical Education - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2017;
  • The latest edition provided by the North Dakota Department of Career and Technical Education;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form SFN16933 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Career and Technical Education.

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Download Form SFN16933 "Continued Education Program Plan Annual Plan/Reimbursement" - North Dakota

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State Capitol 15
th
Floor
600 E Blvd Ave Dept 270
CONTINUED EDUCATION PROGRAM PLAN
Bismarck ND 58505-0610
ANNUAL PLAN/REIMBURSEMENT
Phone 701-328-3180
DEPARTMENT OF CAREER AND TECHNICAL EDUCATION
Fax 701-328-1255
SFN 16933 (11-2017)
ANNUAL PLAN
(This portion must be approved by CTE two weeks prior to the start of class)
School/Institution
Dates of Instruction
From:
To:
Address
City
State
Zip Code
Service Area
☐ Agriculture Education
☐ Health Sciences Education
☐ Technology & Engineering Education
☐ Business Education
☐ Information Technology
☐ Trade, Industry & Technical Education
☐ Family and Consumer Sciences
☐ Marketing Education
State Use
Number of
Estimated
Number of
Hourly
Course Title
Classroom
Total Salary
Enrollment
Sections
Salary
Hours
Rate
Reimbursement
This signature assures that the applying agency does not advocate, permit, nor practice discrimination on the basis of race, color,
national origin, sex, genetics, religion, age or disability as required by various state and federal laws. The authorized official of
applicant organization verifies that the applicant has the legal authority to apply for and receive funding for the proposed activity.
Authorized Signature
Title
Date
STATE USE
Signature of Supervisor
Date
 Approved
 Disapproved
REIMBURSEMENT DATA
(This portion must be completed upon conclusion of class)
Number of
Total
Number of
Hourly
State Use
Course Title
Classroom
Total Salary
Enrollment
Sections
Salary
Rate
Reimbursement
Hours
TOTAL
I certify this reimbursement data is factual, complete and that the courses described meet State Board for Career and Technical
Education minimum requirements for Continued Education. Information provided can be substantiated locally for auditing purposes.
Authorized Signature
Title
Date
State Capitol 15
th
Floor
600 E Blvd Ave Dept 270
CONTINUED EDUCATION PROGRAM PLAN
Bismarck ND 58505-0610
ANNUAL PLAN/REIMBURSEMENT
Phone 701-328-3180
DEPARTMENT OF CAREER AND TECHNICAL EDUCATION
Fax 701-328-1255
SFN 16933 (11-2017)
ANNUAL PLAN
(This portion must be approved by CTE two weeks prior to the start of class)
School/Institution
Dates of Instruction
From:
To:
Address
City
State
Zip Code
Service Area
☐ Agriculture Education
☐ Health Sciences Education
☐ Technology & Engineering Education
☐ Business Education
☐ Information Technology
☐ Trade, Industry & Technical Education
☐ Family and Consumer Sciences
☐ Marketing Education
State Use
Number of
Estimated
Number of
Hourly
Course Title
Classroom
Total Salary
Enrollment
Sections
Salary
Hours
Rate
Reimbursement
This signature assures that the applying agency does not advocate, permit, nor practice discrimination on the basis of race, color,
national origin, sex, genetics, religion, age or disability as required by various state and federal laws. The authorized official of
applicant organization verifies that the applicant has the legal authority to apply for and receive funding for the proposed activity.
Authorized Signature
Title
Date
STATE USE
Signature of Supervisor
Date
 Approved
 Disapproved
REIMBURSEMENT DATA
(This portion must be completed upon conclusion of class)
Number of
Total
Number of
Hourly
State Use
Course Title
Classroom
Total Salary
Enrollment
Sections
Salary
Rate
Reimbursement
Hours
TOTAL
I certify this reimbursement data is factual, complete and that the courses described meet State Board for Career and Technical
Education minimum requirements for Continued Education. Information provided can be substantiated locally for auditing purposes.
Authorized Signature
Title
Date