TxDPS / Texas Department of Public Safety
Education, Training and Research
Employee Development
/ For Field Training Office Use Only
Date received by Field Training / Technician’s Initials / Submitted By:
Date PID verified / PID verified by / Within compliance? Y N
Non-Compliance Memo? Y N
Texas Commission on Law Enforcement
/ Approval to Forward/Enter / Comment / Date sent to Director of Training
e-Mail form to:
Submissions are due no later than (10) days after course end date / Date entered in LMS
/ Entered by / TAMS PCRS#:
Date TCLEDDS upload / Web ID # (Pending Roster) / TID # (Processed Roster)
Page / Instructor
(Required) / TCOLE
Course # (Required) / Hours
Required / Beginning Date
(Required) / Ending Date
(Required) / TCOLE Provider Type and Number
of / / / / / / - Academy – TxDPS #:453001 will submit to TCOLE – course instruction sponsored by TxDPS
- Region 1 - Region 2 - Region 3 - Region 4 - Region 5 - Region 6
(Required) / - Contract Provider will submit to TCOLE – course instruction sponsored by a provider other than TxDPS
Course Title (Required) / Training Location (Required) / - Other (online/seminar/conference)
PID
(Required if applicable) / SSN
Last 4 digits only
(Required if no PID available) / Last Name
(Required) / First Name
(Required) / DPS Service or Other Agency Name
(Required) / D.O.B.
(Required) / License Type
(Required)
1 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
2 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
3 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
4 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
5 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
6 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
7 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
8 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
9 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
10 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
11 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
12 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
13 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
14 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
15 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
16 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
17 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
18 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
19 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
20 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
21 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
22 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
23 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
24 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
25 / / / 0 - Click for License Type1 - Commissioned LEO3 - Telecommunicator4 - Elected Official5 - County Jailer6 - Other/No TX License
THESE STUDENTS HAVE COMPLETED THIS COURSE AND ARE APPROVED TO RECEIVE TRAINING CREDIT.
Field Training Coordinator/Training Approved by (print or sign) / Date (required)
/ / Phone #
() - / Email (Required)
Frank Woodall, Director of Training / Date
ETR-35 05/14