2005 Training Voucher Application 

Please complete the following information and return this application to the NABET Local 51 office along with an approved Application for Educational Assistance available from KDTV or at the NABET website.

NABET Local 51
NABET-KDTV Training Program
433 Natoma St. Suite 220
San Francisco, CA 94103

NAME:________________________            Home Phone:_____________________

 Social Security No:_________________ Work or Cell phone:___________________

 Home Address:________________________________________________________

 City :________________________                                      Zip:__________________

 Email Address:__________________________ 

Course Number

Course Title and Description

Date and Time of Course

 

 

 

 

 Program Eligibility Requirements

 You must be a Member in Good Standing with Local 51 to participate in this program and a Full-Time KDTV employee.  If for any reason you fall into bad standing, after your application has been approved, your application will be revoked immediately. 

You must complete the NABET Training Voucher application (this form) and return it to the NABET office along with an approved Univision Application for Educational Assistance form.

Only classes offered at the Bay Area Video Coalition are available through this program at this time.  The class schedule can be seen at : www.BAVC.org 

I hereby request NABET Local 51 loan me money, interest free, so I can take the class requested on this form, on the terms and conditions set forth:

I understand and agree that once I have been approved by KDTV and the Union to take the class and the class tuition has been paid, the tuition is not refundable and I am obligated to pay NABET Local 51 the full amount of the tuition.   

I agree to the obligation described in this Application upon one (1) of the following conditions, whichever occurs first:  (1) satisfactory completion of the class and submission of the required reimbursement forms to KDTV; whereupon receiving the money from KDTV I will immediately repay the Union for the full amount of the cost of the class or (2) I agree to repay NABET Local 51 for the full amount of the cost of the class within sixty (60) days after the last scheduled class date. 

   In addition I hereby agree to the following:

 

PROMISSORY NOTE  

  $                  San Francisco, California on (today’s date)  

For value received, I promise to pay to NABET-CWA Local 51 the sum of $           , without  interest, from date hereof payable as follows:  full lump sum payment (1) upon receipt of reimbursement from KDTV or (2) no later than sixty (60) days after the last scheduled class date, whichever occurs first. Should I default in this promise and not pay the principal according to the terms herein, the whole sum shall become immediately due to the Union, payable in lawful money of the United States.  If this Note is not paid when due, I promise to pay in addition, all costs of collection and reasonable attorneys’ fees incurred by the holder hereof on account of such collection, whether or not suit is filed hereon.


______________________                                                                                        
Member (signature)                                                               DATE

_______________________________________  
ADDRESS  

_____________                      _________________              _________________  
Home Phone                           Cell Phone                              Work Phone

Application Approved For NABET:  

  _______________________________________     _____________________
 Kevin Wilson, President                                                           DATE