Instructor Application/Removal Form

Instructor Application/Removal Form

State of Minnesota Board of Private Detective and Protective Agent Services
This form should be submitted by Training Providers seeking to add or remove an instructor from a currently approved board-certified course. If

The approval process may take up to 30 days. Prior to submitting this application, please ensure your course meets the requirements for the course type you select. Requirements may be found on the Training page of our website.

If you encounter any issues with this application, please email mn.pdb@state.mn.us
- No training course will be approved without the instructor information as specified, accompanied by an instructor’s resume and the course description to meet the requirements in Board Administrative Rule 7506.2200 and 75.062300 subpart 1 items A through G. Any trainer seeking course approval must include this information on any and all instructors that will or may be used for the course for which you are seeking approval. This material will be evaluated along with course content analysis and will not be reviewed independently of a course application.
- IMPORTANT: An email for each instructor being added is required. Instructors will be sent an email to affirm their understanding of Minnesota Statutes and Rules. This verification is required before the course is approved.
- How many instructors are you adding?*
- Instructors to Remove
- Instructor 1 Name*
  
  First NameLast Name
- Instructor 1: Courses being added to*
  Only include the board-certified course numbers
- Instructor 1 Job Title*
- Instructor 1 Email*
  example@example.com
- Instructor 1 Phone Number*
  Please enter a valid phone number.
- Instructor 1: Select ALL of the following in which you are certified to instruct*
  
  FirearmsFirst AidCPROther Weapons/EquipmentPhysical Restraint TechniquesOther
- Instructor 2 Name*
  
  First NameLast Name
- Instructor 2: Courses being added to*
  Only include the board-certified course numbers
- Instructor 2 Job Title*
- Instructor 2 Email*
  example@example.com
- Instructor 2 Phone Number*
  Please enter a valid phone number.
- Instructor 2: Select ALL of the following in which you are certified to instruct*
  
  FirearmsFirst AidCPROther Weapons/EquipmentPhysical Restraint TechniquesOther
- Instructor 3 Name*
  
  First NameLast Name
- Instructor 3: Courses being added to*
  Only include the board-certified course numbers
- Instructor 3 Job Title*
- Instructor 3 Email*
  example@example.com
- Instructor 3 Phone Number*
  Please enter a valid phone number.
- Instructor 3: Select ALL of the following in which you are certified to instruct*
  
  FirearmsFirst AidCPROther Weapons/EquipmentPhysical Restraint TechniquesOther
- Instructor 4 Name*
  
  First NameLast Name
- Instructor 4: Courses being added to*
  Only include the board-certified course numbers
- Instructor 4 Job Title*
- Instructor 4 Email*
  example@example.com
- Instructor 4 Phone Number*
  Please enter a valid phone number.
- Instructor 4: Select ALL of the following in which you are certified to instruct*
  
  FirearmsFirst AidCPROther Weapons/EquipmentPhysical Restraint TechniquesOther
- Instructor 5 Name*
  
  First NameLast Name
- Instructor 5: Courses being added to*
  Only include the board-certified course numbers
- Instructor 5 Job Title*
- Instructor 5 Email*
  example@example.com
- Instructor 5 Phone Number*
  Please enter a valid phone number.
- Instructor 5: Select ALL of the following in which you are certified to instruct*
  
  FirearmsFirst AidCPROther Weapons/EquipmentPhysical Restraint TechniquesOther
- Instructor Name*
- Instructors - Please list ALL board-certified course numbers you wish to add each instructor to
- Name of Course(s) you will be instructing*
- Board Certified Course Number(s)*
- Please upload the following for EACH instructor:
  - Instructor Resume
  - Instructor certifications
    
    For courses which include First Aid and/or Firearms, certifications in each of these must be included
  - Any other related material
- File Upload
  
  Cancelof
- I AFFIRM THAT THE INFORMATION GIVEN HERE IS, TO THE BEST OF MY KNOWLEDGE, COMPLETE AND ACCURATE AND THE COURSE MATERIAL MEETS THE MINIMUM REQUIREMENTS OF ADMINISTRATIVE RULES 7506.2200 AND
  7506.2300. I AFFIRM THAT A CURRENT RESUME AND CERTIFICATION(S) FOR EACH TRAINER TEACHING THIS COURSE IS ATTACHED TO THIS APPLICATION. I AFFIRM THAT THIS APPLICATION IS ONLY FOR INSTRUCTORS BEING ADDED TO AN EXISTING COURSE THAT WAS PREVIOUSLY CERFTIFIED WITH THE BOARD. I AFFIRM THAT AN APPLICATION IS REQUIRED FOR EACH NEW INSTRUCTOR BEING ADDED TO ACOURSE.
- Signature*
- Name of Person Submitting Application*
- Email of Person Submitting Application*
  example@example.com
- Date*
  
  MonthDayYear
  Date
- At the conclusion of each certified training course, each student who has successfully completed training must be provided by the presenting instructor or person administering the course with evidence of completion (certificate), showing the current instructor, date of course, the subject area covered by each course completed and the number of hours completed.
  
  The instructor(s) or person administering all approved courses has an obligation to advise the Board when an instructor (in person) or on-line course is being ‘decertified.’ By doing so we can remove the course and/or instructor from our list.
  
  Sign and date below to acknowledge your understanding of this rule.
- Signature*
- Name of Person Submitting Application*
- Date*
  
  MonthDayYear
  Date
- Should be Empty: