Licensee Employee Server Training | Pdf Fpdf Doc Docx | Missouri

Licensee Employee Server Training

Missouri/Statewide/Alcohol And Tobacco Control/
Licensee Employee Server Training | Pdf Fpdf Doc Docx | Missouri

Licensee Employee Server Training Form

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This is a Missouri form that can be used for Alcohol And Tobacco Control within Statewide.

Last updated: 5/29/2015
Application to Format Your Organizations Training Program to Meet Division of Alcohol and Tobacco Control Server Training Requirements Last Revised 02/07/2013 MO 829-A0094 American LegalNet, Inc. www.FormsWorkFlow.com Instructions If your organization is intending to provide training to Missouri Sampling Service Employees and you want these employees to receive education hours that can be used to meet their Section 311.297.3(2), RSMo education requirement; then your program/course must be pre-approved by ATC before the training is presented. You must provide the following information (A through F) in order to get your program approved: A. Course/Provider Information for Training (page 3) - This form contains information on your agency/organization, your attendance policy, evaluation plan, and the total number of hours the training takes. B. Instructor Records (page 5) - This form is to be filled out on each instructor that will be teaching the course. C. Objectives of the Course (page 6) ­ This form is to be used to identify the course objectives. D. Instructor's Lesson Plan (page 7) ­ A lesson plan should contain, at a minimum, all of the information covering the course objectives. The lesson plan should be detailed sufficiently that another instructor, with like expertise, with some preparation, could teach the course. An outline will not be accepted as a lesson plan. The course objectives must be clearly identified in the lesson plan. E. Source Document Information for Course (page 8) ­ This form is to be used to identify sources of information the instructor used to develop the course. F. Example of Certificate of Course Completion (page 9) ­ This example contains all of the information that is required of an ATC certificate of course completion. The certificate can look different, but it must contain all of the components. (Submit a copy of the Certificates to ATC) Please submit all of the above information to: Division of Alcohol and Tobacco Control, 1738 East Elm Street, Lower Level, Jefferson City, MO 65101 Please Allow 30 Days for Processing The Training Course Requirement Checklist (page 10) should be used as a final check before sending your course information to ATC. Course Attendance Sign-In sheet (page 4) is to be used to ensure proper attendance throughout the course. If you have any questions, contact ATC at the above address, call (573)-751-2333, or email keith.hendrickson@dps.mo.gov. Page 2 American LegalNet, Inc. www.FormsWorkFlow.com Application to Format Your Organization Training Program ORGANIZATION INFORMATION Organization Name Telephone Number ( Fax Number Address ) ( City ) State Zip Code Telephone Number Contact Person/Administrator E-mail Address (Required) Website ( ) Course Title Attendance Policy To successfully complete a course used to meet the Missouri Division of Alcohol and Tobacco Control Server Training requirement, Attendees absence must not be allowed for any reason, valid or otherwise. Each individual attending this course will sign the Attendance Sign-In Sheet, (see attached example) upon arrival to the class. No attendee may sign for another individual other than himself or herself. Individuals who do not attend the complete hours of instruction will not receive credit for this course, and the Certificate of Completion will be denied. Evaluation Plan Each hour of training must have a minimum of 50 minutes of class time. Each hour of instruction equals to 1 hour of Server Training credit. What does the Attendee have to do to successfully complete this course? (check the appropriate boxes) Attendance & participation Written Test Oral Test Practical Exercise Total Hours of Training (indicate the number of hours Received): No. of Hours Training focuses on updates or familiarization concerning the State Liquor Control Laws. Page 3 American LegalNet, Inc. www.FormsWorkFlow.com COURSE ATTENDANCE SIGN-IN SHEET Name of Course Organization Location Instructors Name Date ATC Control Number NAME (PRINT) NAME (PRINT) I attest that the above signatures are true, and all signed individuals were accounted for prior to beginning of instruction at a.m./p.m. Instructor's Signature I attest that the above signatures are true, and all signed individuals were accounted for at the end of instruction at a.m./p.m. Instructor's Signature Page 4 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTOR RECORD Instructor Information Last Name: Address: Phone: Fax Number: First Name: City: Work Phone: E-Mail Address: Middle Initial: State and Zip: Pager or Mobile: Miscellaneous Instructor Experience Course Being Taught List below the expertise, education and training that qualifies you to instruct this course. (Must attach qualifying certificates or any relevant secondary or third-party licenses.) References ­ list who can best attest that you are qualified to teach this course 1 Reference Name and Address 2 nd st Phone Phone Phone Reference Name and Address 3 Reference Name and Address rd Instructor Attestation I certify that all of the above is accurate to the best of my knowledge Instructor Signature Page 5 American LegalNet, Inc. www.FormsWorkFlow.com Date OBJECTIVES OF THE COURSE COURSE TITLE NOTE: Examples of measurable objectives are terms such as list, define, identify or demonstrate. The terms learn, know and discuss are not good measurable terms. Example: The student will be able to define the elements of a valid ID. OBJECTIVES OF COURSE: At the end of this Server Training course, the student will be able to: OBJECTIVE 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14 NO. OF HOURS . IMPORTANT ­ The course objectives must be clearly identified in the lesson plan. See Page 11 for examples of course objectives. Page 6 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTOR'S LESSON PLAN A lesson plan should contain, at a minimum, all of the information covering the course objectives. The lesson plan should be detailed sufficiently that another instructor, with like expertise, with some preparation, could teach the course. An outline will not be accepted as a lesson plan. Page 7 American LegalNet, Inc. www.FormsWorkFlow.com SOURCE DOCUMENT INFORMATION FOR COURSE COURSE TITLE submitted with the application.) AUDIO-VISUAL MATERIALS USED (title, catalog number, format, year of publication): (This must be TEXT/PUBLICATIONS REVIEWED IN CLASS (title, publisher, year of publication, pages/chapters used): (If manual, workbook, etc. are used by the instructor or s