PTR Training and Certification Interest Form

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Please complete this form if you are interested in participating in PTR training and/or certification.

Email *

Record my email address with my response

First and Last Name of Person Completing this Form *

Email address *

Phone number *

County where you provide service(s) *

I am interested in getting a school site team or teams trained to implement PTR within my district *

Yes

I am interested in getting a person on my school site or district PBIS team certified as a PTR Facilitator *

Yes

I am interested in getting a person on my district or regional PBIS team trained as a PTR Mentor/Trainer so that they can provide local trainings and coaching on PTR. *

Yes

Select the sentence that best describes where your school site or district is with PBIS implementation *

We are not yet implementing PBIS

We are implementing Tier 1 of PBIS and are not yet at 70% fidelity on the TFI

We are implementing Tier 1 at or above 70% fidelity on the TFI

We are implementing Tiers 1 and 2 at or above 70% fidelity on the TFI

We are implementing Tiers 1, 2 and 3 at or above 70% fidelity

NA - I am part of a regional PBIS team supporting local districts and school sites with PBIS implementation

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