Welcome! | National CPS Certification



Course Administrator Application

(Not for Instructors.)

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 Certification or Renewal Testing courses, 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 manual (, click on the link at the top).  

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) 803-4223 or

kchausmer@

Questions? Contact the CPS Certification Program at (202) 662-0639 or kchausmer@

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

8/2016

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