Get Local Pbis Coordinator Information Form-1

Filling out the Local PBIS Coordinator Information Form-1 online is a straightforward process that helps you provide essential information for serving as a PBIS Coordinator. This guide offers clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to access the document and open it in the appropriate online editor.
2. Enter the Local Coordinator Name in the designated field. This should be your full name as it will appear in official documents.
3. Input your Occupation/Job Title. Provide the title that reflects your role within your organization.
4. Fill in the Employer/Organization name. Ensure this is the full name of the institution you represent.
5. Provide the Employer/Organization website. This can help verify your credentials and provide more context about your role.
6. Complete the Employer Address section with the full address including street, city, state, and zip code.
7. Input the Employer Phone and Fax numbers. If either is not applicable, you may leave that field blank.
8. If your mailing address differs from your employer's, fill out the Local Coordinator Mailing Address section with the relevant details.
9. Enter your email address. This will serve as your login name and must be an active account.
10. Create a Preferred Password, ensuring it meets the security requirements: between 8-15 characters, including at least one uppercase letter and one numeric character.
11. Specify the districts for which you will be serving as PBIS Assessment Coordinator. If encompassing all schools, indicate only the district name.
12. List any schools in the district where surveys will be conducted initially.
13. Agree to the terms outlined for using PBISassessment.org by providing your name as a signature and the date.
14. Once completed, you can save changes, download, print, or share the form as required, and submit it to accounts@pbisassessment.org or fax it to (541) 346-2471.

Begin the process of filling out the Local PBIS Coordinator Information Form-1 online today!