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Child and Adolescent Functional Assessment Scale (CAFAS)
Trainer Submission Form

Please select training type: New Rater Booster

New Rater Information

Day 1:

Day 2:

Day 3:

Day 4:

Date:	Start Time:	End Time:	Enter dates in yyyy-mm-dd format. Enter time in hh:mm format.
day 1	day 1 start	day 1 end
day 2	day 2	day 2
day 3	day 3	day 3
day 4	day 4	day 4

Training Cost: Total Fee: $ (Maximum amount cannot exceed $75.00/day of training)
No Fee

Trainer's:

Name:

E-Mail:

Phone:

Training City:

Address:

A valid address is required for mapping.

Details:

Comments:

Audience:

Targeted Case Management
Therapeutic Foster Treatment Care

Class Capacity:

Password:

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Booster Start: (yyyy-mm-dd)
Booster End: (yyyy-mm-dd)
Total Training Cost: Fee $ (Maximum amount cannot exceed $50.00) No Fee
Name:
E-Mail:
Phone:
Training City:
Address:	A valid address is required for mapping.
Details:
Comments:
Audience:	Targeted Case Management Therapeutic Foster Treatment Care
Rater Capacity:
Password: