West Coast Observer Groundfish Training and Debriefing R

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West Coast Groundfish Observer Program Trawl Catch Shares
Training and Briefing Registration Form

Observer Provider

Registration for Training or Briefing
For Internal WCGOP Use Only

Dates of Training/Briefing
Candidates Full Name

Date Received:

Date of Birth
(MM/DD/YYYY)

Trawl Catch Shares Training & Briefing Registration Form v. 2 11/10/2010

Gender

Length of
Contract

Transcripts

Statement Physical Exam
Received
Received

Entered in
Database By

Date Entered
into Database

OMB Control #: 0648-0500 Expiration Date: MM/DD/YYYY

Directions for Observer Providers:
Observer Providers should complete the following fields:
1. Observer Provider: Select the name of your company.
2. Training or Briefing: Document whether the candidates will be attending a briefing or training. Please complete separate forms for trainings and
briefings.
3. Dates of Training/Briefing: Select the training or briefing session.
4. Candidates Full Name: Document the first, middle initial, and last name of the candidate.
5. Date of Birth: Enter the candidates date of birth in MM/DD/YYYY.
6. Gender: Select the candidates gender.
7. Length of Contract: Select the appropriate length of contract. You can also enter your own value into this field. Be sure the value is in days.
If you have questions, contact Rebecca Hoch (206) 437-2415, [email protected]

Public reporting burden for this collection of information is estimated to average 7 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other suggestions for reducing this burden to Janell
Majewski, NWFSC, 2725 Montlake Blvd East, Seattle, Washington 98112. Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subjected to a
penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control
Number.