State of Iowa Department of Administrative Services (das) Information Technology Enterprise (ite) Hoover State Office Building – b level Des Moines, Iowa 50319
FOR NON-STATE EMPLOYEES, PLEASE PROVIDE BILLING INFORMATION:
Non-State Agency/Organization:
Contact:
Phone #:
Address:
City/Zip:
Course Number
Course Title
Date Preference
Alternative Date
Once any course costing $99.00 or less is confirmed, the participant's agency will be billed for the full amount of training unless cancellations are received by PDS at least five (5) working days prior to the class date. For courses that cost $100.00 or more, agencies will be billed for ANY cancellations after confirmation. Departments may substitute confirmed course participants when necessary. To cancel, call (515) 281-5456. (See page 2 for other cancellation information.)
The following signatures indicate approval of the course(s) requested above and understanding of PDS’ cancellation policy.
Employee Name
Employee Signature
Date
Supervisor Name
Supervisor Signature
Date
Training Liaison Name (State Employee Only)
Training Liaison Signature
Date
Accommodation Request
Please indicate if you have any special needs that we can address to make your participation more enjoyable. Please provide 8 weeks notification. Braille Sign Language Interpretation Large Print Other CFN 552-0142 Rev. 6/05
Personnel Development Seminars (PDS)
e-learning Registration Form (2 pages)
(PLEASE PRINT)
Instructions
Fill out the following enrollment form and submit.
A Username and Password and directions will be issued to you by email.
Access to online courses and much more for SkillSoft IT users will be, at anytime, anywhere, 24 hours a day, 7 days a week!
*NOTE: SkillSoft IT users will be on the honor system and will keep their unique username and password private and not give it out to others.
User Information
Name (printed):
SS #:
Email:
Phone:
Department Name:
Division Name:
Information Technology Path (All IT online classes) Access Length (Please check one)
State of Iowa Department of Administrative Services (das) Information Technology Enterprise (ite) Hoover State Office Building – b level Des Moines, Iowa 50319
