Fillable Public Safety Authorization to Bill (Northeast Wisconsin Technical College)

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Public Safety Authorization to Bill (Northeast Wisconsin Technical College)

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The Public Safety Authorization to Bill (Northeast Wisconsin Technical College) form is 1 page long and contains:

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  • 51 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Northeast Wisconsin Technical College

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Public Safety Authorization to Bill
This form authorizes Northeast Wisconsin Technical College to submit for payment and invoice for all
specifed fees related to the training and education of the student(s) listed below:
Name of Organization:
Contact Name:
Address:
Phone:
Email address:
PO # (if applicable):
NWTC Organization ID (if known):
School Year: 20___-20___
Semester: _____ Summer _____ Fall _____ Spring
Invoice for:
Tuition
Required Text Books
Other:
ALL students listed below are authorized to take ALL listed courses.
Catalog #
Class #
Check box that applies:
Name of Student (First, MI, Last)
Student ID or National ID
Email address of attendee
*Attendees will be emailed a confirmation confirming their attendance in addition to the organization contact if this form is received prior to the course
start date.**IMPORTANT NOTE: NWTC reserves the right to substitute the same course, but a different class (time, date, etc.) at the request of the
student without obtaining a new authorization.
Authorizing Signature:
Please complete this ATB and mail, fax, or e-mail to:
Northeast Wisconsin Technical College
Attn: Brandon Peterson
2740 W Mason Street
PO Box 19042
Green Bay, WI 54307-9042
Fax: 920-498-5673
E-Mail: Brandon.Peterson@nwtc.edu
Please note: Enrollment into the requested course is subject to course availability. Questions? Visit http://www.nwtc.edu/myorganization for more information.
Please enroll the following students
Individuals will call to enroll separately
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Public Safety Authorization to Bill (Northeast Wisconsin Technical College)

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Completed 10 October 2020

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