STAFF EDUCATION
&
TRAINING UNIT

 

Application Form

 
Name:
 
 
TAMS Employee ID# Required

Non-DHHS Employees, put an X in box above

A. For all Non-DHHS Employees, please check the appropriate category below:

22
23
24
25 Adults (Cognitive and Physical Disabilities)
26
27

)
CANCELLATION POLICY:A Confirmation notice will be sent to you about one month prior to a program if you are accepted. If you must cancel prior to the program please do so by phone, fax, or using the online cancellation form which is the most accurate way to assure we recieve notification. After two "no-shows", participants will be ineligible for one year of SETU programs.
E-MAIL:dhs.setu@maine.gov WEB ADDRESS:www.maine.gov/dhs/setu/setu.htm Yes)

C. Do you have Internet access?  

D. FOR DHHS EMPLOYEES ONLY (PLEASE CHECK YOUR SERVICE AREA):
1
2
3
4
5
6
7
8
9
10
11
12
14
15 Maine Care Services
16
17
18
19
20

21
E. Please check the box for the type of position which you now hold:(Check all that apply to you)
                         
F. Please indicate Class title, Class number, location, and date:
Has this request for training been approved by your supervisor?
If your application is accepted, you will be notified no later than two weeks prior to the beginning of the selected program.                                        You will NOT be notified if your application is denied.
If you have any questions concerning this form, please contact us at 624-7936