Employee Resources       TDCJ Intranet       Contact Us       Información en Español

Rehabilitation Programs Division

Clinical Training Registration Form

Course Title
Location

I Wish To (Check One):

Host a Class     Attend a Class

Suggested Course Dates*

Last Name
First Name
Agency/Organization
Job Title
License/Certification Type
License/Certification Number
Telephone
E-mail Address
Comments

* - Dates of training are subject to instructor availability.

View the TDCJ privacy and security policy regarding information submitted via this form.

Employee Resources | Report Waste, Fraud, and Abuse of TDCJ Resources | State Agency Energy Savings Program | TDCJ Intranet
Site Policies | Texas Correctional Industries | TexasOnline | Texas Veterans Portal | Texas Homeland Security | TRAIL Statewide Search | Adobe Reader
Texas Department of Criminal Justice | P.O. Box 99 | Huntsville, Texas 77342-0099 | (936) 295-6371