Pennsylvania Safety and Driver Education Teacher ...

Pennsylvania Safety and Driver Education Teacher Certification Assessment Registration

To apply to take the PSDETCA, please complete the following registration. Please print or type in blue or black ink.

Once the application is submitted, you will receive notification as to your scheduled test date and time. The test is administered on the first Tuesday and third Thursday at 1:00 P.M. Allow approximately two hours to take the test.

Name: _______________________________________________________________________

PPID Number: ______________

Date of Birth___________________

Street Address: ________________________________________________________________

Apartment Number: ___________________________________________________________

City: _________________________________________________________________________

State: ________________________________________________________________________

Zip Code: ____________________________________________________________________

Daytime Telephone Number: ____________________________________________________

Email Address: ________________________________________________________________

Requested test date(s): __________________________________________________________

Signature: _____________________________________________________ Date: _________

Submit your complete application to:

johkashatu@

or Mr. John V. Kashatus

or

Fax: 717-783-3946

School Safety Education Advisor

Pennsylvania Department of Education

333 Market Street, 3rd. Floor

Harrisburg, Pa. 17126-0333

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