Request for Baton Training

Request for Baton Training

Course Accreditation

Complete all sections of this form and attach requested documents. Incomplete or illegible application will be returned without review. This document can be completed on the computer and printed for signature.

Note about application form: This application form has been created for immediate use and does not have built-in features that allow applicants to fill in check boxes. Applicants may have to complete part of form by hand.

Part 1 – Applicant Information
Company Name
Phone (with area code) / Fax (with area code) / Web Address
Physical Address / Unit/Suite/Apt.
City / Province / Postal Code
Mailing Address (if different from above) / PO Box
City / Province / Postal Code

Name of Owner(s) or Branch Manager (add a separate sheet of more space is required)

Last Name / First Name / Email Address
Phone (with area code) / Cell (with area code) / Fax (with area code)

Contact Person for Training Course Development (this person will be contact by SGPS staff with any questions regarding the application or content)

Last Name / First Name / Email Address
Phone (with area code) / Cell (with area code) / Fax (with area code)

Provide contact information for specific members of your staff who will be able to assist with verification of training certification for past students:

Primary Contact for Verification:

Last Name / First Name / Email Address
Phone (with area code) / Cell (with area code) / Fax (with area code)

Alternate Contact for Verification:

Last Name / First Name / Email Address
Phone (with area code) / Cell (with area code) / Fax (with area code)
Part 2 – General Information

1. Application Type: Type of training environment:

o New Accreditation o In-house training course

o Renew Accreditation o Contract service provider

o No changes to previous application (do not complete Part 3) o Public education facility

Attach the following: o Current Course Outline o Private training centre

o Proof of insurance

o  Changes to previous application (complete Part 3) and attach

all supporting documents

2. Does the company wish to be listed on the Security Programs web site as an approved course provider? o Yes o No

3. How many instructors will you employ (both full and part-time)?

List all instructors with current accreditation or pending applications for accreditation (attach a separate sheet if more space is required)

Full Name / Accreditation # or “Submitted” / Expiry Date
5. Does the company have more than one location providing this course? / o Yes o No ATTACH LIST WITH ADDRESS, PHONE, CONTACT PERSON AT SITE
Will the course be offered at clients’ facilities? / o Yes o No
6. Record Keeping (required for audit purposes):
How long does the company keep student records?
Where are student records physically stored?
7. Does the company carry minimum $1 million in liability insurance? / o Yes o No attach copy of proof of insurance
Part 3 – Accreditation Criteria
Review accreditation criteria above to explain what is required in each section below. All sections must be completed.
o / Course Description: Provide a general description of the course being presented for accreditation.
o / Scope: Identify who the course is intended for, jurisdictions (i.e. Edmonton, Calgary) and delivery methods.
o / Program Length: Indicate full length of course and length of baton training segment.
o / Course Development: Identify the sources for course for the baton training content.
o / Training Material Source: Provide list of sources used to compile training materials generally and the baton training materials specifically.
o / Course Content: Attached expanded table of contents, course outline or manual with allotted training time per section and learning outcomes for the baton training section.
o  Course outline or manual attached
o / Instructor Certification Standards: List courses, certifications required by all instructors, including basic first aid training.
o  Instructor accreditation applications attached
o  Instructor accreditation applications submitted separately
o / Instructor Student Ratio: Indicate the ratio of instructors to students for the baton training portion of the course.
o / Candidate Prerequisites: List any prerequisites that must be met by students prior to entering this course.
o  No prerequisites required
o / Resources/Equipment: List all resources and equipment used in baton training sessions.
o / Training Methodology: Describe how the course was developed and the development team and how the baton training section was developed and the development team.
o / Testing Process: Explain how and when students are tested throughout the training process and the pass/fail grade.
o / Acknowledgement of Pass: Provide sample of letter or certificate issued to students on successful completion of course.
o  Letter or certificate attached
o / Proof of Liability Insurance: Must demonstrate minimum $1 million liability insurance.
o  Insurance documents attached
Part 4 – Acknowledgements and Declaration

I agree that I will follow the Security Services and Investigators Act Training Accreditation Policy, as amended from time to time by the Registrar.

Initial: ______

I agree to on-site audits of my training curriculum, in-class activities, final testing, training records, instructor credentials and any other records required by the Registrar.

Initial: ______

I agree to notify the Registrar prior to substantially altering the accredited course of instruction to ensure that the course can continue to remain accredited for training under the Security Services and Investigators Act.

Initial: ______

I declare that the above statements are true and I understand that providing false or misleading information to the Registrar is an offense.

I understand that the information collected on this form or under the Security Services and Investigators Act, Regulation(s) and Policy Manual is collected by or for the Registrar under the authority of the Act, and that it will be used to determine eligibility for accreditation of training courses, compliance and any use as prescribed by the Act and Regulation.

I also understand that personal information is protected under the Freedom of Information and Protection of Privacy Act (FOIP) and it can only be used and disclosed in accordance with the FOIP. Direct any questions about collection of this information to: Security Programs, Public Security Division at 780-427-3457 or by email to .

Dated (yyyy-mm-dd):
Name of Applicant: / Applicant’s Signature:
please print

Submit completed application to (Courier and drop-off at reception, 9th floor):

Security Programs

Alberta Solicitor General and Public Security

10th Floor, 10365-97 Street

Edmonton, AB T5J 3W7FOR SGPS STAFF COLLEGE USE ONLY

Reviewer’s Name: Phone:

o  Returned application package – incomplete Date:

o  Checklist of missing items attached

o  Approved Accreditation Date:

o  Declined Accreditation Date:

Reasons (attach separate sheet if needed):

FOR PUBLIC SECURITY DIVISION USE ONLY

Accreditation # 20_ _ - ______

o  Acceptance Letter and certificate issued Date:

o  Decline Letter issued Date:

o  Returned package as incomplete or illegible (provide dates)

Date: Registrar Approval:

Staff init:

Baton Training Course Accreditation Guidelines and Application – 2010/09/30 Page 1 of 4

Security Services and Investigators Act – Alberta Solicitor General and Ministry of Public Security