Alaska SEED Trainer Approval Application

To translate the form into Spanish or another language (Para traducir el formulario al español u otro idioma):

Open the form using Google Chrome web browser. Download Chrome here. (Abra el formulario con el navegador web Google Chrome. Descarga Chrome aquí.)
Anywhere on this form, right click and you will see a drop-down menu. (En cualquier lugar de este formulario, haga clic con el botón derecho y verá un menú desplegable.)
Select “Translate to …” (Selecciona "Traducir a ...".)
Choose the language you would like it to be translated to. (Elija el idioma al que le gustaría que se tradujera.)
Repeat steps 2-4 on each new form page. (Repita los pasos 2 a 4 en cada nueva página de formulario.)

A. Application Type

Is this a provisional, basic, or specialized application?

ProvisionalBasicSpecialized

B. Contact Information

First Name

Middle Initial

Last Name

Organization/Affiliation

Phone

Email

Website

Address

City

State

Zip Code (5-digit)

Are you on the Alaska SEED Registry? All trainers must enroll in the Alaska SEED Registry to become a SEED Approved Trainer. If you are not a member of the Alaska SEED Registry, go to akportal.naccrraware.net/alaska/

YesNo

SEED Level

SEED Expiration Date

C. Training Received

A combined total of 6 hours of training or coursework in Principles of Adult Learning (PAL)

Training Title

Training Date

Training Organization

Hours/Credits

D. Documentation

Please submit a copy or proof of qualifications meeting current license, certificate, or transcript of training or coursework below:

Upload file

E. Statement of Understanding

By submitting and signing this application:

I certify that the information on this application is true and accurate to the best of my knowledge.

Signature

Date

Applications will be processed in order of receipt within 30 business days.