Get Applicant Information Eligibility Information - Texas Department Of ... - Dshs State Tx

Filling out the Applicant Information Eligibility Information form with the Texas Department of State Health Services is a key step for candidates seeking certification. This guide will walk you through the process of completing each section of the form accurately and thoroughly.

Follow the steps to successfully complete your application form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the candidate’s name in the "Candidate’s Name" field. Ensure you print clearly to avoid any confusion.
3. Fill in your title under the 'Title' section. This helps clarify your professional role.
4. Provide the agency's name in the 'Agency' field. This should be the organization affiliated with the applicant.
5. Input the dates of service in the designated field. This information reflects your tenure relevant to food safety.
6. Enter your home telephone number to ensure they can reach you easily.
7. Provide your office email address in the corresponding field for professional communication.
8. Fill in the office telephone number, making sure it is correct and direct.
9. Input your office fax number if applicable; this may be required for documentation purposes.
10. Complete the 'Office Mailing Address', ensuring the city, state, and zip code fields are filled accurately.
11. Proceed to fill out the 'Home Address' section with your residence details, including city, state, and zip.
12. In the 'Eligibility Information' section, outline your formal education or training related to food safety.
13. Confirm completion of the curriculum for Retail Food Safety Inspection Officers, and attach copies of related certificates.
14. List your current duties in the field of food safety training under 'Present Duties Conducting Food Safety Training and/or Standardization'.
15. Provide information regarding your continuing education, ensuring you list the required hours and course titles within the last two years.
16. Check the box confirming your completion of other prerequisites. Only one box needs to be checked.
17. Have your supervisor sign in the designated 'Supervisor’s Signature' section to confirm the request for nomination.
18. Finally, review all entries for accuracy. Save your changes, and you can choose to download or print the completed form.

Complete your application form online today for efficient processing!