Name
*
First Name
Last Name
Participant E-mail
You will receive an email copy of this form for your records.
Alternate E-Mail
Use this email address to send a confirmation of training to a supervisor, if required.
Contracting Entity (CE) Name
*
CE Identification Number (CE ID)
5-digit number used in TX-UNPS
Are you a supervisor responsible for the food service at this CE?
*
Yes
No
Assigned ESC:
*
Please Select
01 - Edinburgh
02 - Corpus Christi
03 - Victoria
04 - Houston
05 - Beaumont
06 - Huntsville
07 - Kilgore
08 - Mt Pleasant
09 - Wichita Falls
10 - Dallas
11 - Fort Worth
12 - Waco
13 - Austin
14 - Abilene
15 - San Angelo
16 - Amarillo
17 - Lubbock
18 - Midland
19 - El Paso
20 - San Antonio
Date
/
Month
/
Day
Year
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