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911 PUBLIC SAFETY TELECOMMUNICATOR RE-EXAM APPLICATION
DO NOT SEND EXAM FEES WITH THIS APPLICATION.
A. Applicant Information
Attempt # Date/Location of Last Exam
Last Name First Name Middle Initial Date of Birth
Mailing Address City State Zip Code
Phone Number Email Address - *All correspondence will be sent to the email address provided.
B. Employment Status
I am not currently employed as a PST
I am currently employed as a PST by
Training Program Completion
Part V: Additional Information / Applicant Signature
________________________________ am the person referred to in this application. All statements
contained herein and in any attachments hereto are true, correct and complete.
Applicant Signature: Date:
Mail applications to:
Florida DOH / 911 PST Program
4052 Bald Cypress Way, Bin A-22
Tallahassee, FL 32399
C. Testing Qualifications