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Training Application Form

If enrolling in a class taught by CCI, you will also need to fill out a CCI Application For Training form. Please note that for CAC sponsored classes, CAC members are not excluded from the eligible student list if their CCI application lacks a supervisor’s or agency’s signature. This form will be sent electronically directly to the Chairperson of the Training and Resources Committee.

Title of Class:

Personal Information

Your Name:
Your Title:
Employer Address:
Employer City, State, Zip:
,
Phone Number:
Fax Number:
Email:
   
CAC Membership Status:
Full/Associate/Corresonding
Affiliate
Retired
Not a Member
   
Are you willing to attend this class on your own expenses if your agency does not sponsor you?
Yes
No
   
I attest that I satisfy any prerequisites necessary to attend the class and I understand that CAC members get first priority in filling the class.