RTAP Approved Trainer Data Entry Portal

Welcome to our data entry portal for Kansas RTAP Approved Trainers. Use this portal to enter information on each class taught, subjects taught in that class, and who attended the class.

Trainer Information

Last Name

First Name

Agency

CTD

Class Information

Class Entered on Black Cat Calendar?

Yes

Date Entered

Date of Training

Subject(s) Taught

RTAP Defensive Driving

RTAP Passenger Assistance

RTAP Emergency Procedures

RTAP Advanced Mobility Securement

# RTAP Defensive Driving Class Hours

# RTAP Passenger Assistance Class Hours

# RTAP Emergency Procedures Class Hours

# RTAP Advanced Mobility Securement Class Hours

Total Number of Class Hours

Was this Class at a Location Outside of Your Agency?

Attendee Information

Participant First Name 1.

First Name *

Participant Last Name 1.

Last Name *

Participant Agency 1.

Agency *

Participant Works for Your Agency? 1.

Works for Your Agency? *

Participant First Name 2.

Participant Last Name 2.

Participant Agency 2.

Participant Works for Your Agency? 2.

Participant First Name 3.

Participant Last Name 3.

Participant Agency 3.

Participant Works for Your Agency? 3.

Participant First Name 4.

Participant Last Name 4.

Participant Agency 4.

Participant Works for Your Agency? 4.

Participant First Name 5.

Participant Last Name 5.

Participant Agency 5.

Participant Works for Your Agency? 5.

Participant First Name 6.

Participant Last Name 6.

Participant Agency 6.

Participant Works for Your Agency? 6.

Participant First Name 7.

Participant Last Name 7.

Participant Agency 7.

Participant Works for Your Agency? 7.

Participant First Name 8.

Participant Last Name 8.

Participant Agency 8.

Participant Works for Your Agency? 8.

Participant First Name 9.

Participant Last Name 9.

Participant Agency 9.

Participant Works for Your Agency? 9.

Participant First Name 10.

Participant Last Name 10.

Participant Agency 10.

Participant Works for Your Agency? 10.

Participant First Name 11.

Participant Last Name 11.

Participant Agency 11.

Participant Works for Your Agency? 11.

Participant First Name 12.

Participant Last Name 12.

Participant Agency 12.

Participant Works for Your Agency? 12.

Participant First Name 13.

Participant Last Name 13.

Participant Agency 13.

Participant Works for Your Agency? 13.

Participant First Name 14.

Participant Last Name 14.

Participant Agency 14.

Participant Works for Your Agency? 14.

Participant First Name 15.

Participant Last Name 15.

Participant Agency 15.

Participant Works for Your Agency? 15.

Participant First Name 16.

Participant Last Name 16.

Participant Agency 16.

Participant Works for Your Agency? 16.

Participant First Name 17.

Participant Last Name 17.

Participant Agency 17.

Participant Works for Your Agency? 17.

Participant First Name 18.

Participant Last Name 18.

Participant Agency 18.

Participant Works for Your Agency? 18.

Participant First Name 19.

Participant Last Name 19.

Participant Agency 19.

Participant Works for Your Agency? 19.

Participant First Name 20.

Participant Last Name 20.

Participant Agency 20.

Participant Works for Your Agency? 20.

Have More than 20 Participants?
Submit the first 20 participants on this form and then fill out the form again for additional participants.

A confirmation of the information you entered will be sent to your email address, for your records.