Attachment_13-FSB_Training_Certification_Request_Form.pdf

Northeast Fisheries Science Center

Fisheries Sampling Branch Observer Programs

FSB TRAINING CERTIFICATION REQUEST FORM

Provider Company:__________________________ Date of Training Request:____________

Training Certification Type: Select Only one Training Certification Type per form

Number of Candidates Requested:________________________________________

(Minimum of eight total required for a class)

Training Date(s)/Time Range Requested:_____________________________________________________

Justification of Need:______________________________________________________________________

Additional Considerations:_________________________________________________________________

Requested By (Name): __________________________ Date:___________________________

Special Note-Review Process:

Upon completion of all fields within this request form, a review will be conducted at the subsequently scheduled FSB Projected Training Schedule meeting. Decisions and feedback will be provided thereafter by FSB Staff to the requesting Provider.

Part 1: To Be Completed by the Provider Requesting Training

ASM Initial Training (11 days):_____

ASM Specialized

NEFOP to ASM Cross (5 days):_____

ASM Recertification I or II (1 or 3 days):_____

NEFOP Initial Training (15 days):_____

NEFOP Specialized

ASM to NEFOP Cross (7 days):_____

Shrimp Trawl (1 day):_____

Longline (1 day):_____

Pot Trap (1 day):_____

Clam Quahog Dredge (1.5 days):_____

High Volume Fishery (1.5 days):_____

IFS Initial Training (13 days):_____

IFS Specialized

ASM to IFS Cross: (9-10 days):_____

Safety I Training (2.5 days):_____

Safety II Training (2 days):______

Safety III Training (1day):______

Other Training Request:___________

Attachment 13

EA133F-17-RP-1824 SECTION J

FSB Staff Received By (Name):________________________ Date Request Received: _______________

Any modification to the original request with justifications outlined below and recommended by FSB Staff: (Notes from training meetings specifics who, when and reasons)

Result of Request: Approved:______ Rejected:______

FSB Projected Training Date:_____________________

Final Result By (Name):__________________________ Date of Result:_______________________

Justification of Result:

Part 2: To Be Completed by FSB Staff Only

Attachment 13

EA133F-17-RP-1824 SECTION J