Free NEBRASKA WORKERS' COMPENSATION COURT - Nebraska

NEBRASKA WORKERS' COMPENSATION COURT

( VR-37C )

Post-Secondary Training End of Term Report
Pursuant to Rule 37 C, if this report is not received at the court on or before the end of the first day of classes of the new term, the authorization for training costs is subject to cancellation.

Student/Client __________________________________SS # ________ ____ ________
(Please Print)

College/University __________________________ City _________________________ Degree: Certificate____ Diploma ____ Associate's Degree____ Bachelor's Degree____ Area of Concentration/Program of Study_______________________________________

Grades for Term Ending: _______________________
(End Date)

Course Number

Course Title

Grade

Credit Hours

Comments

Term GPA _______ Cumulative GPA _______

Class Schedule for Term Beginning: _____________
(Start Date)

___________
(End Date)

Course Number

Course Title

Credit Class Days Hours M T W T F S

Total Hours _______ I certify that I have reviewed official documents in order to provide the above information, certify that it is correct, and that all courses listed are requirements or approved electives for the student's program of study. ________________________________
(Vocational Rehabilitation Counselor Signature)

______________________ ___________
(NWCC Certification Number) (Date)