Employee Details First Name Last Name Email Phone Current Department Host Department Current Supervisor Details First Name Last Name Email Phone Host Supervisor Details First Name Last Name Email Phone Director Details First Name Last Name Email Phone Training Information What areas are you interested in and what would you like to gain from the host department?(Request Summary) Scheduled Date of Initial Tour Scheduled Time of Initial Tour Will there be additional shadowing and/or training from the host department? No Yes How will your duties be performed in your current department during your absence? Training Start Date: Training End Date: Training Schedule: Who will be responsible for the training in the host department? Goals (List 3-5 goals you would like to accomplish): Training Plan Summary (Briefly explain the plan using additional paper if necessary): Resources (List required materials needed to complete training):