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APPLICATION NYC DEPARTMENT OF CITYWIDE ADMINISTRATIVE SERVICES |CITYWIDE (NYC Department of Information Technology and Telecommunications)

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I I I I I I I I
NYC DEPARTMENT OF CITYWIDE ADMINISTRATIVE SERVICES |CITYWIDE TRAINING CENTER
APPLICATION
Please review the instructions on
the next page before completing this
application.
CTC OFFICE USE ONLY
Input Date Initials
TRAINING APPLICANT INFORMATION (must ll all elds)
Employee Reference
Employee Afliation: (Check One)
Today’s Date
Number (See Pay stub)
City
State
ederalF
No n-Gov.
Last Name
First Name Middle initial
Civil Service Title
Ofce Title
Agency Name
Agency Code
I have changed agencies
Ye s
within the last 2 years
No
Division/Work Unit
Work Address (full)
Work Phone
Work Fax
Work Email
Personal Email
OPTIONAL APPLICANT INFORMATION
Gender Are you Hispanic? What is your race?
Asian
I do not want to disclose
Female
Ye s
Black
Two or more races
Male
No
White
I do not want to disclose
I do not want to disclose
American Indian or Alaskan Native
SELECTED COURSE INFORMATION
Course Code
1
Course Title
Level Course Dates Days
Cost
2
3
4
CITYWIDE TRAINING CENTER CONFIRMATION/CANCELLATION POLICY
1. Your agency training liaison will notify you of your conrmation to attend the class(es) for which you
have registered.You should not attend a class for which you have not received a conrmation. If you have
not received a conrmation, check with your liaison. No food or beverages are permitted in classrooms.
2. Requests for cancellations or scheduling must be received in writing at least 7 business days prior
to the start of a conrmed class. Requests received without the required notice will result in a charge
of the full course fee.Agencies may designate a qualied participant for substitution up to the
commencement of the class without penalty.
APPLICANT SIGNATURE
Applicant Signature Date
REVIEW THESE INSTRUCTIONS BEFORE COMPLETING APPLICATION
Applicant completes all elds in the TRAINING APPLICANT INFORMATION section and includes
required Employee Reference Number (NOT Social Security Number) found on pay stub. First-time,
non-City applicants will be assigned a CTC ID number.
Applicant completes all elds in the SELECTED COURSE INFORMATION after selecting courses
from the current Citywide Training Center Class Schedule or contacts the Agency Training Liaison for
additional course information.
Applicant forwards completed application to immediate Supervisor for signature and authorization.
Supervisor forwards completed application to the appropriate Agency Training Liaison for processing.
Agency Training Liaison forwards application to Agency Fiscal Ofcer or Designee for scal authorization.
Agency Training Liaison signs and forwards completed, authorized applications to the Citywide Training
Center,Applications Processing Unit.
*NOTE: The CTC will process applications under the assumption that Training Liaisons have obtained all
necessary permissions.
SUPERVISOR AUTHORIZATION
Supervisor’s
Title
Name (Print)
Work Fax Work Email
Work Phone
By my signature, I certify that this employee is authorized for training in the course(s) requested and
conrm that this employee has taken, where applicable, the prerequisite basic courses and/or has
demonstrated the skill necessary to participate successfully in advanced-level coursework.Additionally,
I understand that this employee is excused from normal work assignments during the hours of training
and is required to attend the training course(s), as scheduled, once CTC registration conrmation is
received by the Agency Training Liaison.
Supervisor Signature Date
FISCAL OFFICER /DESIGNEE AUTHORIZATION
Fiscal Ofcer or
Title
Designee’s Name (Print)
Work Fax Work Email
Work Phone
By my signature, I certify that funding in the appropriate budget/object codes is available for the training
requested and that all training costs will be paid in accordance with DCAS/Citywide Training Center
payment procedures.
Fiscal Officer Signature Date
AGENCY TRAINING LIAISON AUTHORIZATION
Agency Training
Title
Liaison Name (Print)
Work Phone
Work Fax Work Email
By my signature, I certify that I have reviewed this for content and completeness.
Agency Training Liaison Signature Date
The NYC Department of Citywide Administrative Services (DCAS) is committed to Equal
Employment Opportunity (EEO) and a policy of non-discrimination in the employment, development,
advancement and treatment of City employees.
DCAS will provide reasonable accommodations to employees with disabilities who need and request
such accommodations.
If you require an accommodation or a support service, please call us at (212) 386-0005 or email us
at citywidetrainingcent@dcas.nyc.gov.
CITYWIDE TRAINING CENTER
APPLICATIONS PROCESSING UNIT | 1 CENTRE STREET, 24TH FLOOR SOUTH | NEW YORK, NY 10007
PHONE: 212-386-0005
| FAX: 212-313-3439 | EMAIL: citywidetrainingcent@dcas.nyc.gov
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APPLICATION NYC DEPARTMENT OF CITYWIDE ADMINISTRATIVE SERVICES CITYWIDE (NYC Department of Information Technology and Telecommunications)

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Completed 4 August 2020

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