Safe Transportation for All Children (STAC) Class Registration Request

Safe Travel for All Children (STAC) -Interest Form

THIS IS NOT A REGISTRATION FORM
Please complete the form as we gather interest for scheduling upcoming STAC classes in Florida.

Contact Danielle.Kessenger@nsc.org with any questions about possible locations, dates, fees.

Note: Completing this form does not guarantee participation in a STAC class.
Full Name*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Agency / Hospital / Clinic*
Department - if applicable
City*
County*
Zip Code*
How will you use what you learn from this training?
What is your CPS Tech #*
What is your expiration date?*
Are there other CPST with the STAC enrichment training in your agency/department?*
Please describe your reason(s) for taking this class. Choose all that apply*

I am required to have this enrichment training for my job positionI am excited to learn more about how to mitigate special transportation needs for my patients and their familiesI will use it as a resource for families in my area as there are no CPST with this enrichment trainingI work with families who have one or more children who have Autism diagnosisI am curious about special needs options in the vehicle
Location for ALL 2026 STAC Classes

South Manatee Fire Rescue, Sarasota, FL 34243
Dates: 1st preference*

February 10-11, 2026 *canceled due to low registration*March 30-31, 2026May 28-29, 2026September 2026 (dates pending)Keep my info for a future option
Dates: 2nd preference*

March 30-31, 2026May 28-29, 2026September 2026 (dates pending)Keep my info for a future option
Should be Empty:

Safe Travel for All Children (STAC) -Interest Form