TABE Regional Trainer Certification Workshop

Application for

TABE Regional Trainer Certification Workshop

(Note: Practitioners who complete this TABE Train-the-Trainer Workshop will need to participate in an actual TABE training with the FLDOE/CTB training team before they will be released to do regional training on their own.]

Part 1: General Information

Name:_____________________________________________ Date:______________________

Home Address_____________________________________________________________________

___________________________________________________________________________________

Telephone: Home_________________________ Office________________________________

Fax: Home Office

Agency/Employer Name and Address, Telephone, Fax, and E-Mail:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Your Title/Position:_________________________________________________________________

Length of time in this position:_____________________________________________________

Would you like to receive correspondence at work or at home?_______________________

What is your reason for applying to become a certified regional TABE trainer? ______________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________

Part 2: Trainer/Presenter Experience

List all of your experience either as a presenter or trainer. Attach an additional sheet if more space is needed.

________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________

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Describe the best presentation or training session you have ever attended and explain why it was exceptional._____________________________________________________________

What do you think effective training should include?

How many people have you trained or had in attendance at your presentations during the past year? List each presentation separately. (Use an extra page if necessary.)

____________________________________________________________________________________

Part 3: Service Delivery and Impact

Do you supervise teachers or other professionals who directly provide literacy, adult basic education, or GED instruction to adult students? If yes, how many?

________________________________________________________________________________________________________________________________________________________________________

Do you personally provide direct service to adult learners in an educational setting? If yes, describe the setting and the number of adults served.

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Please describe the limitations on your availability for providing day-long training to administrators/instructors needing TABE training in your region? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Part 4: Supervisor’s Approval and Signature

Please have your supervisor sign below to indicate approval for your participation and support for you to conduct the follow-up training as required in your region.

(Note: this application cannot be accepted without supervisor’s signature.)

_____________________________________________________________________________

Supervisor’s Name and Title (Please Print)

______________________________________________________________________________

Supervisor’s Signature Date of Signature

______________________________________________________________________________

Applicant’s Signature

Part 5: Applicant’s Commitment for Training

I understand that by attending the TABE Certification Workshop, I must commit to presenting jointly with the FLDOE/CTB training team a minimum of one time and that I will be willing to conduct TABE training in my region through the appropriate Regional Training Center (RTC). All resources for this regional training will be provided either by the RTC, CTB/McGraw-Hill, and/or the agency/institution hosting the training.

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Applicant’s Signature Date

Submit this completed application no later than March 16, 2007 by email to or via fax to Mario Zuniga at 850.245.0995.

RK Revised: 12-6-06