AgingNY Case Management Staff Sign-up Form

AgingNY Case Management Staff Sign-up Form

2024-2025 Training Cohort

Agency Training Contact*

Please note this form should be completed by the County Director or Training Liaison

Email Address*

Please note this form should be completed by the County Director or Training Liaison

Phone Number*

Please note this form should be completed by the County Director or Training Liaison

Phone

New York County*

Please note this form should be completed by the County Director or Training Liaison

Number of staff to train*

Please note this form should be completed by the County Director or Training Liaison

Participant List*

Please upload an excel sheet that includes the following information for each participant:

First & last name
Email address
Program(s) selection
New Hire Case Management (6-course program)
Recertification Case Management (6-course program)
Recertification Test Option

Please note: staff that are signing up for the recertification test option will also be added to the Aging with Intellectual and Development Disabilities online course.

Drag and drop files here or

Training Acknowledgements*

I understand I am listed as a designated contact for the CADER client service team.

I understand I will review monthly training reports provided by the CADER client service team.

I understand my agency will support staff participating in training program.

I understand that in order to ensure available slots are fully utilized I will identify challenges and alert the appropriate leadership

Send me a copy of my responses

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