ASAP-NYCB Training Approval submission form

Trainer Attestations

To be completed by Trainer or Training Manager

Name of Trainer *

Course Title *

ASAP-NYCB Trainer Registry # *

Training Agency *

Contact name *

Contact email *

Contact tel *

Date *

Hereby attests :

I am a member in good standing of the ASAP-NYCB Trainer Registry *

I have attached a personal statement of my course specific training approach and engagement style, a summary of my experience with this training content, and any previous class feedback *

I have attached a Curriculum Inventory *

I confirm that, for initial certifications (CRPA & CARC), I will deliver a minimum of 46 instructional hours (16 in the domain of Ethical Responsibility) *

I understand that, for the above initial hours, synchronous training only is accepted *

I will deliver this training to a maximum class size of 25 participants (initial certifications only) *

I confirm the presence of all technical and support requirements (audio/video; flip charts, etc.) *

I have attached a statement of my cancelation/refund policy *

I have attached a copy of my course evaluation form *

I will issue training completion certificates bearing my personalized NYCB training approval badge to all participants who successfully complete this course *

I will support my participants in their pursuit of professional certification through NYCB *

I will maintain a formal attendance record, and make it available to NYCB, upon request *

I will cooperate with NYCB program monitoring procedures *

I understand that Trainer Registry membership expires. I will seek renewal in a timely fashion to ensure continuance of training approval *

I will advise NYCB of any changes to curriculum or training personnel in a timely fashion

I will advise NYCB of any changes to my trainer registry membership status in a timely fashion *

I understand that ASAP-NYCB will advise me in a responsible and timely fashion of any updates, amendments or changes to the terms of this understanding *

(signed): *

Clear Signature

(dated): *

Course Specific Trainer Statement

One form to be completed by named Trainer (or Trainer Manager)

Name of Trainer *

Course/Training Title *

ASAP-NYCB Trainer Registry # *

Provide specific examples of how you plan on delivering the material named above (e.g. lecture, small group work, etc.), and how this will help learners meet course objectives? *

What experience do you have that qualifies you to deliver this specific content effectively, (e.g. you are an authorized trainer in this subject, material is based on your practical experience, etc.) *

If you have delivered this course previously, please provide a summary of any feedback received and how you plan on using it to improve the training experience for upcoming classes. *

Course Inventory

To be completed by Trainer or Training Manager | Please submit as many forms as necessary

Name of Trainer *

Course Title *

Course Author (individual and/or publisher) *

Course Inventory already approved *

Please confirm with your training vendor if this Course Inventory has already been submitted and approved.

Please give vendor name/email *

ASAP-NYCB Trainer Registry # *

Training Agency *

Contact name *

Contact email *