INTENT TO PAY

INTENT TO PAY

Knox Technical Center
(Note: This form is to be filled out by the company expressing their intent to pay for some or all of the student's tuition. This is not to be filled out by the student)

Instructions for the Company representative:
- Please list below the student(s) for whom your department will cover the costs for training at Knox Technical Center.
- Please see the current cost on our website at https://www.knoxtechnicalcenter.com/programs.html
- Indicate which career program they will be attending along with the start date. (One program per form)
- This form must be submitted 1 week prior to the start date of the class.
Company Name*
Billing Address*

Street Address

Department

CityState / Province

Postal / Zip Code
Company's Telephone Number*
Name of KTC Program*
Start Date*

MonthDayYear
Date
Student's Name*

First NameLast Name
Student's Telephone Number
Student's Email
example@example.com
I have more students to add:*

YESNO

Additional Students
Student's Name

First NameLast Name
Telephone Number
Email
example@example.com
Student's Name

First NameLast Name
Telephone Number
Email
example@example.com
Student's Name

First NameLast Name
Telephone Number
Email
example@example.com
Student's Name

First NameLast Name
Telephone Number
Email
example@example.com

Please indicate payment option:

Payment will cover the full cost of the programA fixed amount will be given to the student towards the programOther
Program costs can be found using the link: https://www.knoxtechnicalcenter.com/programs.html
If fixed dollar amount, please enter the amount below.
COMPANY REPRESENTATIVE: By signing this form I confirm that the above student(s) will be attending the noted career program and their program fees will be paid by our company.
Name

First NameLast Name
Title
Email
example@example.com
Authorized Signature*

Clear
Should be Empty: