Application For Training Reimbursement

An application for a training reimbursement shall be accepted only for approved training successfully completed not more than 180 days before the date of this application request. Applicant must hold a current Maryland Child Care Credential of Level Two or higher.

INSTRUCTIONS: Complete all information in the spaces provided. All applications must be accompanied by required documentation. Incomplete applications will not be processed. 

Personal Information
Federal Tax Form 1040 - Line 22
Check the appropriate box.

Training Information: 

Only training completed within the past SIX months may be reimbursed.

Attach copies of :

  • Receipt of payment indicating the amount paid for the training
  • Certificate of successful completion, grade slip or transcript. (Documentation must include the name of the participant, the date of training, training title, name of Trainer or organization, and , if applicable, the OCC assigned approval number.)
  • Files must be less than 2 MB.
    Allowed file types: txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.
Files must be less than 2 MB.
Allowed file types: txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.
Files must be less than 2 MB.
Allowed file types: txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

All information on this application is true and accurate to the best of my knowledge. I understand that any false statement on this application will result in being denied reimbursement; being required to repay the amount reimbursement; and/or no longer be eligible for training reimbursement.