TABE 701 12.2.09 St. Petersburg
 
Date: December 2, 2009

Time: 9:00-1:00

Location:
12425 28th Street North, Suite 300
St. Petersburg, FL 33716
Phone: 727-556-3000

TABE 701 is for experienced TABE test administrator who has already received his or her initial certificate and is fulfilling the recommended re-certification.

Trainer: Jiske Ong
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1. Attendee Last Name

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2. Attendee First Name

3. E-mail Address

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4. Title/Position (i.e., GED instructor, Volunteer tutor, etc.)

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5. Name of your school/agency/organization

6. County

7. Mailing Address (Street)

8. City

9. State

10. Zip

11. Telephone Number (with area code)

12. I have received authorization from my supervisor to attend this training

13. My supervisor's name is

14. My supervisor's email address is

15. PLEASE NOTE: Travel requests must be submitted by Wednesday, Nov. 17th. Requests received after Nov. 17th cannot be processed.

I will not be reimbursed by my organization and am requesting travel reimbursement from The Region IV Training Council for

16. If you have requested travel reimbursement (Question 15), please provide your HOME ADDRESS including city and zip code.

17. Questions or comments: