Bureau of Criminal Apprehension
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Bureau of Criminal Apprehension Criminal Justice Training & Education Training Request Form
COORDINATOR INFORMATION
Last First
Agency
Street Address
City State ZIP
Phone E-mail Address
COURSE INFORMATION
Course Title
Dates Times
Post Credits Course Cost
Location (include Address)
Course Prerequisites:
Course Description:
Course Sponsorship:
Audience (i.e. law enforcement, dispatchers, etc.):
Number of Students:
Yes No Will students register for course on the BCA CJTE site? (registration through this site is for BCA classes, or classes sponsored or done in partnership with the BCA. This is required for course rosters, POST credits, certificates, etc.)
Training Room Requested:
W-278 Computer Classroom (capacity 22) W-272 West Class (capacity 30)
W-273 East Class (capacity 30) W-277 Multi Purpose (30)
W-249 Lab (40) W-270 Auditorium (capacity 150)
INSTRUCTOR NAMES PLEASE INCLUDE INSTRUCTOR RESUME WITH REQUEST. Yes No Is an instructor contract needed?
Full Name Title
Phone ( ) Email Address
Full Name Title
Phone ( ) Email Address
Last revised date: 4/15/2010 Equipment Needed*: Food:
Laptop Yes No If yes, please indicate if you will provide or if BCA will be handling.
Overhead Projector
Proxima Breakfast: Speakers Lunch: Slide Advancer Breakouts: Flip Charts
Extension Cord Any other details/special requests:
Power Strip
Key Cards
IT Support (i.e. access to internet)
*Please note: Our Equipment only supports Office 2007.
Yes No Clerical help needed: this is provided to BCA sponsored courses. Which includes handouts/materials, certificates, name tents, rosters, etc.) If yes, someone will contact with clarification of what is needed.
Yes No Certificates
Yes No Name Tents
Yes No Roster/Sign-in sheet
Yes No Copies of Handouts/materials. (All handout materials must be emailed to [email protected] no later than 2 weeks prior to the course. Presenters are responsible for their own handouts if they fail to meet this timeline).
Signature Date
FOR CJTE OFFICE USE ONLY REVIEWED BY Title
APPROVED BY Title
DATE APPROVED
DATE POSTED
Yes No
Special Expense
Purchase Order
Instructor Contract
POST #
Last revised date: 4/15/2010