National Standardized Child Passenger Safety Training Program



Course Administrator Application

Name:

Agency:

If you have a CPS Online profile (EX: you are a CPST), this detail is already on file and you can skip this section. SKID#: ___________ (or CPST#). Not sure? Fill this in, please.

Mailing Address:

City: State: Zip:

Daytime phone number: ( ) Fax: ( )

Email address:

As a Course Administrator, you can add a Certification or Certification Renewal course, review the course roster, make basic course edits and edit the instructor team.  For controlled courses, you will also be able to review Reservation Requests.

Please review the policies on our website () under Course Administration and the details in the Policies and Procedures (, click on the link on the upper right) manual.  

How many courses do you anticipate administering annually?

Please list the Instructors you anticipate working with:

|Instructor Name (Please print) |Certification ID (CPSTI #) |

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Please return this application to: CPS Certification Program

fax # (202) 393-2072 or

kchausmer@

Questions? Contact a member of the CPS Certification Program at (202) 662-0619.

NOTE: The Instructors listed above will be notified of your request.

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