California > Statewide > Department Of Alcoholic Beverage Control
Responsible Beverage Service Training Provider Application ABC-801 - California
| Responsible Beverage Service Training Provider Application Form. This is a California form and can be used in Department Of Alcoholic Beverage Control Statewide . |
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Department of Alcoholic Beverage Control State of California RESPONSIBLE BEVERAGE SERVICE TRAINING PROVIDER APPLICATION Submit completed application and support material (indexed and labeled in detail) to the Department of Alcoholic Beverage Control, RBS Training Provider Program, 3927 Lennane Drive, Suite 100, Sacramento, California 95834 Support material includes, but is not limited to: ·Course Outline that identifies the page number where each curriculum standard is located. (For DVD's, Power Point, etc. list specific reference, i.e., Scene number, Slide number, etc.) · Instruction Curriculum · Classroom Materials (including workbooks, DVD/videos, electronic presentations, examinations, handouts, etc.) · Completed Form ABC-802, Responsible Beverage Service Training Provider Summary, and supporting documents · Signed Authorization (On business letterhead authorizing the Department and the RBS Advisory Board to retain and utilize copyrighted material in order to review and evaluate applicant's program for certification and future renewing of certification.) PROVIDER NAME (If individual: First Middle Last) A preliminary review of the application and support materials will be made, and if the program, as presented, meets the training level standards, a provisional approval will be given. Upon a provisional approval, the RBS Project Coordinator will contact the Provider Applicant for an onsite review of the training program. After the on-site review, a full summary report will be submitted to the RBS Advisory Board for a final evaluation of the complete training program. Training programs passing the final evaluation will receive Certification. Please note: Support material will not be returned to applicant. The Department will retain and store the material for program reference. APPLICATION TYPE Original Program Change Renewal BUSINESS PHONE NUMBER PROGRAM NAME FAX NUMBER BUSINESS ADDRESS (Street number and name, city, state, zip code) COUNTY WHERE BUSINESS IS LOCATED EMAIL ADDRESS MAILING ADDRESS (Street number and name, city, state, zip code) CONTACT NAME (First Middle Last) PHONE NUMBER EMAIL ADDRESS FAX NUMBER APPLICATION ENTITY GEOGRAPHICAL AREA SERVED Individual Partnership Corporation Trade Association Other: BUSINESS TYPE(S) TO RECEIVE TRAINING National Statewide Regional County-wide: City-wide: Liquor Store Supermarket Winery County Fair Street Scene Special Events PROGRAM WILL BE GIVEN TO (check ALL that apply) Bar Restaurant Convenience Store TRAINING LEVEL Level One (Basic Awareness) Level Two (Professional Server) Level Three (Manager) PERSON SUBMITTING APPLICATION (First Middle Last) Internal Only On-Sale Licensed Premises Employees Off-Sale Licensed Premises Employees PROGRAM HAS BEEN IN EXISTENCE FOR (Years and/or months) SIGNATURE DATE SIGNED ABC-801 (7/07) American LegalNet, Inc. www.FormsWorkflow.com
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