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APD > Registration Form for APD's Train-the-Trainer

Your Contact Information

Please fill in all of the information below:
(* Denotes Required Field)

First Name:	*
Last Name:	*
Email Address:	*
Agency Name:	*
Address:
City:
State:
Zip:
Telephone: (Including Area Code)
APD Area in which training will be provided:
Years of Training Experience:
Accommodation(s) Needed:

To register for APD's Train-the-Trainer course, you must be pre-approved by each APD area office in which you plan to train. Once one area has signed this form, email or fax it to Melinda_Coulter@apd.state.fl.us and copy JB_Black@apd.state.fl.us or you may mail it to their attention at:

Agency for Persons with Disabilities
4030 Esplanade Way
Tallahassee, FL 32399

Class Schedule and Registration

Please select the training classes that you would like to register for. You may register for more than one class.

Once you have made your selection, please select the "Send Form" button at the bottom of the page. You should receive an email at the address you provided above confirming the receipt of your request.

You must print out the confirmation email and bring it with you the day of class.

** Class sizes are limited. Registration does not guarantee a seat in the class.

Core Competencies
Training	Date	Registration Deadline
Session 1 - Ft Lauderdale	December 15 - 16, 2008	December 12, 2008
Session 2 - Orlando	January 14 - 15 , 2009	January 9, 2009
Session 3 - Tallahassee	February 18 - 19, 2009	February 13, 2009

Zero Tolerance
Training	Date	Registration Deadline
Session 1 - Ft Lauderdale	December 16 - 17, 2008	December 12, 2008
Session 2 - Orlando	January 15 - 16 , 2009	January 9, 2009
Session 3 - Tallahassee	February 19 - 20, 2009	February 13, 2009