Fillable CFLE Voucher Form (Winthrop University)

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CFLE Voucher Form (Winthrop University)

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B.S. in HDFS
CFLE Voucher Request Form
Submit all completed CFLE Voucher Request Forms, along with all required CFLE application
documents, to Dr. Pamela Wash or Ms. Curlene Moise in Withers 204.
_________________________________________ W______________________
Student Name (Last, First, Middle) Student WID
_________________________________________ ________________________
Winthrop Email Address Phone (XXX-XXX-XXXX)
Please complete the following indicating which CFLE Provisional Certification you are
seeking:
$135 (I am a current NCFR member)
$185 (I am not a current NCFR member)
By signing below, I acknowledge that I understand that the appropriate fee for the CFLE
application listed above will be immediately charged to my Winthrop student account upon
submission of this signed form.
________________________________________ ________________________
Student Signature Date
OFFICE USE ONLY
Date Received
Date Verified
Date Memo Sent to Student Financial
Services
Amount Charged to Student Account
Processed By
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CFLE Voucher Form (Winthrop University)

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Completed 23 July 2020

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