Driver Refresher Training

Primary Contact Information. Please provide contact information for the manager or administrative support person who is coordinating this registration.

* Required field

Agency*

Primary Contact Name*

Primary Contact E-mail*

Phone*

Emergency Phone Number - will be used in case of class cancellation

Street Address*

City*

Zip Code*

Please select a date and location

Saturday, January 12, 2013
8 a.m. to Noon
Tri-Cap - Waite Park

Saturday, January 19, 2013
8 a.m. to Noon
Paul Bunyan Transit - Bemidji

Saturday, March 2, 2013
8 a.m. to Noon
Cedar Valley Services - Albert Lea

Please tell us the names of the drivers who will be attending this class on this date. You may register up to five drivers at one time. If you are registering for more than one date, please complete additional forms.

IMPORTANT: Before Registering drivers for a DRIVER REFRESHER TRAINING, you must verify that each driver you has completed ALL of the following prior to taking this training:

•  The driver(s) has successfully completed 8 – hours of Passenger Assistance Training
•  The driver(s) has successfully completed 4 – hours of Defensive Driving Training
•  The driver(s) has successfully completed 4 – hours of Maltreatment Awareness (aka Abuse  Prevention) Training.

If these are all complete, check this box:*

RTAP Trainers reserve the right to ask drivers to leave if they have not completed all of the above before attending this training.

Name*

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