Advanced, Specialized & Homeland Security Training Authorization Form Officer Information Rank: Last Name: First Name: SSN: Agency: Course Information MIDDLE MANAGEMENT COURSE Course Title: AUGUST 20-24, 2018 8Am - 5Pm Course Dates: Course WTC / CITRUS COUNTY PUBLIC SAFETY TRAINING CENTER Course Location: 1201 West Main Street Inverness, Florida 34450 Salary Incentive Mandatory Training Course will be used for: Agency Approval To be placed on your agency’s list to attend this course, you must fax or this form to your Training Section so they can forward the form to CCPSTC/WTC. Please go through your Training Section for all training requirements. Name of person authorizing attendance: Signature: Signer’s Telephone Number: Date: Signer’s Email Address: Registration To be placed on the course list, please return this completed form after receiving your agency’s approval. Forms may be faxed or emailed to: Debora D’Alto, Program Manager Fax: (352) 249-2155 d’altod@citrus.k12.fl.us
Advanced, Specialized & Homeland Security Training Authorization Form Officer Information Rank: Last Name: First Name: SSN: Agency: Course Information Course Title: MIDDLE MANAGEMENT COURSE Course Dates: AUGUST 20-24, 2018 Course 8Am - 5Pm Course Location: WTC / CITRUS COUNTY PUBLIC SAFETY TRAINING CENTER 1201 West Main Street Inverness, Florida 34450 Course will be used for: Salary Incentive Mandatory Training Agency Approval To be placed on your agency’s list to attend this course, you must fax or this form to your Training Section so they can forward the form to CCPSTC/WTC. Please go through your Training Section for all training requirements. Name of person authorizing attendance: Signature: Signer’s Telephone Number: Date: Signer’s Email Address: Registration To be placed on the course list, please return this completed form after receiving your agency’s approval. Forms may be faxed or emailed to: Debora D’Alto, Program Manager Fax: (352) 249-2155 d’altod@citrus.k12.fl.us