Contact List

Minnesota RTAP Contact List Form

The purpose of this form is to build our contact list and improve communications about training opportunities. Thank you for taking the time to complete.

Name of Agency*

Let us know if you are completing this form for yourself only or others.

Completing for yourself

Your Name*

First Last

Your Email*

Your Job Title*

Job Category*

Job titles aren't always descriptive of actual job duties.

Please select all that apply to your job.

Define "Other" Job Category:

Your Supervisor*

First Last

Your Supervisor's Job Title*

Your Supervisor's Email

Communications Consent*

By selecting the box below I consent to Mn RTAP to contact me via email. I understand I may update my contact information or request to be removed from the email list at anytime by contacting Mn RTAP.

I consent

Completing for your team

USE WHICHEVER OF THESE THREE OPTIONS WORKS BEST FOR YOU:

1) Complete the fields below for each person (5 max).
2) Download the Contact Spreadsheet (Excel document). Complete and save to your computer. Upload using the tool below. OR
3) Upload an org chart or any other document that will provide the contact information we are requesting.

IF YOU UPLOAD FILES: Don't forget to click SUBMIT below when you are done.

Upload File

Upload an org chart or other document with relevant information instead of, or in addition to, completing the fields below.

Max. file size: 32 MB.

Name

First Last

Email

Job Title

Job Category

Job titles aren't always descriptive of actual job duties.

Please select all that apply to this person's job.

Define "Other" Job Category:

Supervisor

First Last

Supervisor's Job Title

Supervisor's Email

Add a second person?

Yes.
No.

Second person

Name

First Last

Email

Job Title

Job Category

Job titles aren't always descriptive of actual job duties.

Please select all that apply to this person's job.

Define "Other" Job Category:

Supervisor

First Last

Supervisor's Job Title

Supervisor's Email

Add a third person?

Yes.
No.

Third person

Name

First Last

Email

Job Title

Job Category

Job titles aren't always descriptive of actual job duties.

Please select all that apply to this person's job.

Define "Other" Job Category:

Supervisor

First Last

Supervisor's Job Title

Supervisor's Email

Add a fourth person?

Yes.
No.

Fourth person

Name

First Last

Email

Job Title

Job Category

Job titles aren't always descriptive of actual job duties.

Please select all that apply to this person's job.

Define "Other" Job Category:

Supervisor

First Last

Supervisor's Job Title

Supervisor's Email

Add a fifth person?

Yes.
No.

Fifth person

Name

First Last

Email

Job Title

Job Category

Job titles aren't always descriptive of actual job duties.

Please select all that apply to this person's job.

Define "Other" Job Category:

Supervisor

First Last

Supervisor's Job Title

Supervisor's Email

Max reached. Thank you for completing this form. Select Next to continue.

You may add up five people and yourself using this form. If you have more people on your team, consider uploading a document with the information. Upload tool is available in the next screen.

Next

Thank you!

Thank you for completing the form. If you wish to upload a document, use the tool below.

Upload File

OPTIONAL:

Upload an org chart or other document with relevant contact information.

Select SUBMIT when complete.

Max. file size: 32 MB.

Minnesota RTAP Contact List Form

Completing for yourself

Completing for your team

Second person

Third person

Fourth person

Fifth person

Thank you!