Exhibit_C_-_Pre-ETS_Workshop_Attendance_Sheet.docx

DOCX document 24 KB Posted

Attached to
Master Agreement AZ|CTR056121
Contract number
CTR056121
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 RSA email domain (azdes.gov). The form is designed to track participation in vocational rehabilitation services for students, with space to record workshop details, service type, and participant information.

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. Participants are required to initial the roster, and the document includes fields for recording student details such as date of birth and Pre-ETS authorization from both state Rehabilitation Services Administration (RSA) and local Vocational Rehabilitation (VR) offices. The form is intended to be completed and submitted to RSATransition@azdes.gov after workshop completion, with the version dated June 2018.

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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 .