Educational Release Time Request Form
NC-2001, Educational Release Time Rule
Human Resource Director Review for eligiblity:
Employee Name
CRN
Course Title
Class time
Mon
Tues
Wed
Thurs
Fri
Sat
Credit Hrs
Start Date
End Date
# of Weeks
Institution Offering Class
hours/week
hours/week
Must be a regionally accredited institution.
Department
Not to exceed 3 credit hours in 1 semester
Travel time requested
Educational Release Time
Job Related
Pursuing degree
Employee
Comments:
Employee Signature
Comments:
Date
Signature
Supervisor Review:
Approved Denied
Comments:
Signature
Denied
Approved
Date
Department Administrator Review:
Date
Signature
DeniedApproved
Date
Major
Credits needed
How:
Periodic attendance
required
Semester
Comments:
Type
Explain
Print Form
WVNCC
1/5/12
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