Exhibit_C_-_Pre-ETS_Workshop_Attendance_Sheet.docx

DOCX document 24 KB Posted

Attached to
Master Agreement AZ|CTR056087
Contract number
CTR056087
Issued by
Arizona

About this file

This document is an attendance sheet for Pre-Employment Transition Services (Pre-ETS) from the Rehabilitation Services Administration, likely in Arizona based on the email domain (azdes.gov). The form appears to be used by a contracted vendor to track student participation in various pre-employment support services for individuals with disabilities, potentially through a state vocational rehabilitation program.

The attendance sheet covers five specific Pre-ETS service categories: Job-Exploration Counseling, Work-Based Learning Experience, Counseling on Post-Secondary Education, Workplace-Readiness Skills Training, and Instruction on Self-Advocacy. The form requires detailed student information including name, date of birth, and authorization status from both the Rehabilitation Services Administration (RSA) and local vocational rehabilitation office. The document was revised in June 2018 and instructs vendors to submit completed rosters to RSATransition@azdes.gov after workshop sessions are concluded.

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Text version

PRE-EMPLOYMENT TRANSITION SERVICES

REHABILITATION SERVICES ADMINISTRATION

ATTENDANCE SHEET

Service Date: Start Time: End Time: e.g., 9:00 am Service Location:

Contracted Vendor: Presenter:

|_| Job-Exploration Counseling |_| Work-Based Learning Experience |_| Counseling on Post-Secondary Education |_| Workplace-Readiness Skills Training |_| Instruction on Self-Advocacy

Subtopic (Required): _________________________________________________________________ Service/Activity Participant(s) Students: please initial below to signify attendance.

Student Name

(PLEASE TYPE OR PRINT LEGIBLY)

Date of Birth

Pre-ETS Authorization Received from RSA Transition
Pre-ETS Authorization Received from Local VR Office

One roster per workshop session. Please send to RSATransition@azdes.gov after the completion of all workshop sessions under a specific Pre-ET service category. Revised June 2018

File details come from the government source that posted it. Updated .