OSPI Program Changes
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OSPI Program Changes
Driver training schools can use this form to report personnel changes or to report program closure. Send this completed form to:
Driver Training Schools Department of Licensing PO Box 9027 Olympia WA 98507-9027
Email: tse@dol. Fax: (360) 570-4976
School information
PRINT or TYPE School name
Registration number
School street address, City, State, ZIP code Check this box if new address
Contact name
Contact title
(Area code) Telephone number
Email
Add/Remove staff Instructors/Examiners?New instructors/examiners must first be approved by OSPI. Email: K12TSE@k12.wa.us for approval.
Name exactly as it appears on their driver license/ID card (Last, First, Middle initial/name) DOL certificate number Date of birth (mm/dd/yyyy) OSPI use only
Status
Add
Delete
Position
Instructor
Examiner
Knowledge only
Approved
(Area code) Telephone number
Email
Staff/Support
Name exactly as it appears on their driver license/ID card (Last, First, Middle initial/name) DOL certificate number Date of birth (mm/dd/yyyy)
Status
Add
Delete
(Area code) Telephone number
Position
Staff
Email
Examiner support
TSE Coordinator/Superintendent
Name exactly as it appears on their driver license/ID card (Last, First, Middle initial/name) DOL certificate number Date of birth (mm/dd/yyyy)
Status
Add
Delete
(Area code) Telephone number
Position
TSE Coordinator
Email
Superintendent
Program closure
Answer the following if the TSE program is closing
Have you: 1. Confirmed that all course completions have been entered into SAW portal? . . . . . . . . . . . . . . . . . . . . . . Yes No 2. Provided a list of any students that have not completed the course? . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No 3. Provided a student record for any student that has not completed the course? . . . . . . . . . . . . . . . . . . . . Yes No 4. Verified that all test scores have been entered into the portal? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No 5. If applicable, verified that all unused copies of the knowledge and skills exams have been destroyed? . Yes No
I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.
Date and place signed DTS-661-039 (R/8/19)WA
PRINT or TYPE Name
X When you have completed this form, please print it out and sign here.
Signature
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