Form 700-010-41 "Instructor Request for Fdot's Construction Training Qualification Program" - Florida

What Is Form 700-010-41?

This is a legal form that was released by the Florida Department of Transportation - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2017;
  • The latest edition provided by the Florida Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 700-010-41 by clicking the link below or browse more documents and templates provided by the Florida Department of Transportation.

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Download Form 700-010-41 "Instructor Request for Fdot's Construction Training Qualification Program" - Florida

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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
700-010-41
CONSTRUCTION
INSTRUCTOR REQUEST
12/17
FOR FDOT’S CONSTRUCTION TRAINING QUALIFICATION
PROGRAM
Submit To: FDOT State Construction Training Administrator
605 Suwannee St., Mail station 31
Tallahassee, Florida 32399-0450
Or email to:
Susan.Robeson@dot.state.fl.us
Contact Details to post on website
Name:
Name:
TIN:
Provider(s):
Address:
Address:
Email address:
Phone number:
Phone number:
Email address:
(see CTQM 1.11(1) for details)
(see CTQM 1.11(2) for details)
Seeking Approval as a CTQP Instructor for the following course:
(Each course desired will require a separate Instructor Approval Request form to be submitted)
Check the boxes for the corresponding documentation submitted with this request
(see CTQM 1.11(4) & 1.11(5) for details)
I have attached my resume (REQUIRED)
(The Applicant must attach a copy of their resume. This resume must convey experience qualifying them to be considered as an Instructor for
the FDOT CTQP course requested.)
I have taken a “Train the Trainer” workshop and have attached documentation
I have held a valid teaching certificate and have attached documentation
I have teaching experience in this technical field and have attached documentation
I am a recognized expert in this field and knowledgeable on this subject area and have attached documentation
Any other information the prospective Instructor considers will assist the TRT in evaluating this application
____________________________________________________
Signature
Date
Print Name
The Applicant may be required to demonstrate their abilities and knowledge at a regular meeting of Technical Review Team of the
Specialty Area in which they are requesting approval.
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
700-010-41
CONSTRUCTION
INSTRUCTOR REQUEST
12/17
FOR FDOT’S CONSTRUCTION TRAINING QUALIFICATION
PROGRAM
Submit To: FDOT State Construction Training Administrator
605 Suwannee St., Mail station 31
Tallahassee, Florida 32399-0450
Or email to:
Susan.Robeson@dot.state.fl.us
Contact Details to post on website
Name:
Name:
TIN:
Provider(s):
Address:
Address:
Email address:
Phone number:
Phone number:
Email address:
(see CTQM 1.11(1) for details)
(see CTQM 1.11(2) for details)
Seeking Approval as a CTQP Instructor for the following course:
(Each course desired will require a separate Instructor Approval Request form to be submitted)
Check the boxes for the corresponding documentation submitted with this request
(see CTQM 1.11(4) & 1.11(5) for details)
I have attached my resume (REQUIRED)
(The Applicant must attach a copy of their resume. This resume must convey experience qualifying them to be considered as an Instructor for
the FDOT CTQP course requested.)
I have taken a “Train the Trainer” workshop and have attached documentation
I have held a valid teaching certificate and have attached documentation
I have teaching experience in this technical field and have attached documentation
I am a recognized expert in this field and knowledgeable on this subject area and have attached documentation
Any other information the prospective Instructor considers will assist the TRT in evaluating this application
____________________________________________________
Signature
Date
Print Name
The Applicant may be required to demonstrate their abilities and knowledge at a regular meeting of Technical Review Team of the
Specialty Area in which they are requesting approval.