Training Nomination And Employee Assessment Delegated Examing Training {OPM 1674}

U.S. Office of Personnel Management TRAINING NOMINATION FORM Initial Delegated Examining Certification Training Location of Training: First Choice Second Choice Training Dates: First Choice (MM/DD/YY) Second Choice (MM/DD/YY) Name of Nominee: Pay Plan: Series: Grade: Title: Email: Type of Employment: Current Federal Employee Years Contractor Months Length of Federal Staffing Experience: If length of Federal staffing experience is less than 6 months, please indicate below the titles of Federal staffing courses you have successfully completed. (You may be asked to provide a copy of the certification for verification.) Do you need special accommodations? No Yes (specify): Agency Name: Agency Address: DEU ID Number: Agency Point-of-Contact (if different from nominee): Phone: Nominee's Signature: Date: Supervisor's Name: Supervisor's Signature: Date: OPM 1674 October 2014 American LegalNet, Inc. www.FormsWorkFlow.com