Employee Training Certificate Request Form

Employee Training Certificate Request Form

Pursuant to issuing a Training Certificate, It is required that The Guardian/Monitech/LifeSafer/Quickstart Trainer has trained the service center representatives utilizing the official State Service Center Manual and/or completed all assigned LifeSafer University courses, a minimum of 8 hours of instruction.
LifesaferMonitechGuardianQuickstart
Date Trained:*

MonthDayYear
Service Center Name:*
Street/Mailing Address:*
City:*
State:*
Employee/Contractor Information
Name:*
InstallMonitorAdministrationState RegulationsReportingIID OperationCLE Hours (6) (FL)
Drivers License #:*
Expiration Date:*

MonthDayYear
Trainer Confirmation
Trainer's Name:*

First NameLast Name
Trainer's Signature:*

Clear
Use the mouse cursor to sign your name
Field Manager/TrainerService Center/Employee/Contractor
Service Center/Employee/Contractor Email:*
Field Manager/Trainer Email:*
**Certificates will be emailed after submission**
Should be Empty: