Circular 96-07 Appendix B

NOTE:  This agreement must be signed by the nominee for all non-government training that exceeds 80 hours and for which the government provides payment of training costs prior to the commencement of such training.

1. I AGREE that upon completion of the Government sponsored training described in this request, that, if I receive salary covering the training period, I will serve in HHS three times the length of the training period.  If I receive no salary during the training period, I agree to serve the HHS for a period equa1 to the length of training, but in no case less than one month.  (The length of part-time training, is the number of hours spent in class or with the instructor.  The length of full-time training is eight hours for each day of training up to maximum of 40 hours a week.)
2. If I voluntarily leave HHS before completing this period of service, I AGREE to reimburse HHS for the tuition and related fees, travel and other special expenses (EXCLUDING SALARY) paid in connection with my training.
3. I FURTHER AGREE that, if I voluntarily leave HHS to enter the service of another federal agency before completing the period of service, I will give my organization written notice of at least ten workdays, during which time a determination concerning reimbursement will be made.  If I fail to give this advance notice, or do not receive written notice of waiver of payment or transfer of my obligation to the gaining agency, I AGREE to repay the amount of additional expenses incurred by the Government in this training.
4. I understand that any amounts which may be due HHS as a result of any failure on my part to meet the terms of this agreement may be withheld from any monies owed by the Government, or may be recovered by such other methods as are approved by Law.
5. I FURTHER AGREE to obtain approval from my organization training officer and that person responsible for authorizing non-Government Training Requests of any proposed change in my approved training program involved course and schedule changes, withdrawals or incompletions, and increased costs.
6. I fully understand that this agreement does not in any way commit the Government to continue my employment.

(Date Signed)__________________ (Signature)_______________________________