Registration Confirmation

Please submit this page only once!

First Name:

      Last Name
                       ( As it is to appear on your certificate (no "nicknames," please.)

Role (Director, Test Administrator, Instructor, etc.

Organization/Community College

Direct Supervisor:

Email Address

Phone Number:

What training will you attend for CASAS Central Region beginning December 1?:
    New Users       DD       ESL       BIT

Should you plan to attend, please download and save this additional information before you submit your registration. It contains materials for your review.

Acknowledge that you have downloaded the form:      Yes             No

After submitting, please print the next page for your records!

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Updated by Judy Howell Wednesday, January 11, 2012 09:24:45 AM

First Name:
Last Name ( As it is to appear on your certificate (no "nicknames," please.)
Role (Director, Test Administrator, Instructor, etc.
Organization/Community College
Direct Supervisor:
Email Address
Phone Number:
What training will you attend for CASAS Central Region beginning December 1?: New Users DD ESL BIT
Should you plan to attend, please download and save this additional information before you submit your registration. It contains materials for your review. Acknowledge that you have downloaded the form: Yes No
After submitting, please print the next page for your records!