Response Document LPN Certificate Programs Qualifying Final 3 21 23~1.docx

Full-time LPN Certificate Programs at Massachusetts Technical Schools RFR

Commonwealth of Massachusetts Department of Developmental Services Response Document

This form must be completed according to the instructions below. Requirements include completion of questions and submission of required forms.

Provider Name

Primary Contact Person

Provider Address

E-mail Address

Vendor Code

Phone Number

Backup Contact Person

E-mail Address

Phone Number

Certification

I certify that the statements made in this proposal are true and complete to the best of my knowledge.

Signature of Authorized Agency Representative Date

I. Brief Description of Technical School’s Full-time LPN Certificate Program Please provide a brief description of your school’s full-time LPN certificate program. Include the following: Program duration, Number of courses required, Total credit hours, Total tuition, Associated Fees and Any related expenses required for a student to complete the program.

II. Description of Invoicing Please provide a brief description of your organization’s proposal to invoice the Department of Developmental Services for employees enrolled in your organization’s full-time LPN Certificate program and accepted to the DDS LPN Certificate Career Ladder program that DDS is implementing. DDS intends to cover the cost of the tuition and fees on the employee’s behalf.