Assessment Center Registration Form
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Please use this form to register your school, agency or business as a Florida Ready to Work
Assessment Center. An organization may have multiple Assessment Center locations. Please
submit a separate form for each Assessment Center. Upon receipt of the form, the Primary
Contact will be contacted by a Florida Ready to Work Project Coordinator to verify
registration as a Florida Ready to Work Assessment Center within 2 business days.
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Note: * equals Required Fields.
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Click the "What Is This?"
The "What Is This?" Icon
Click these icons for additional information about a given field.
icon for additional information about a particular field.
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Assessment Center Information
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Physical Location of program delivering FRW assessments, as appears on signage or how the
program is best known. This is how the Assessment Center will be listed on the FRW website.
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Assessment Center Name:
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Assessment Center Name
This field indicates the name of the physical location of your school, agency or
business that will deliver the Florida Ready to Work program, as it appears on
signage or how the program is best known. This is how the Assessment Center will
be listed on the Florida Ready to Work website. This is a required field.
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Physical Address:
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Assessment Center Physical Address
This field indicates the physical location of your school, agency or business that
will deliver the Florida Ready to Work program. This is the Street Address that
will be listed on the Florida Ready to Work website. This is a required field.
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City:
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Assessment Center City
This field indicates the City in which your school, agency or business is located.
This is a required field.
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State:
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Assessment Center State
This field indicates the State in which your school, agency or business is located.
This is a required field.
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Zip:
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Assessment Center Zip
This field indicates the Zip Code of the physical location of your school, agency or
business that will deliver the Florida Ready to Work program. This is a required field.
The value for this field must be in the format ##### or #####-####.
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County:
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Assessment Center County
This field indicates the County in which your school, agency or business is located.
This is a required field. Please select the appropriate County from the drop-down list.
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Type:
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Assessment Center Type
This field indicates the population served by your school, agency or business and the
streams through which your Assessment Center is funded. This is a required field.
Please select the correct Type from the drop-down list.
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Population:
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Assessment Center Population
This field indicates the population served by your school, agency or business to which
you will provide the Florida Ready to Work program. This is a required field. Please
select the correct Population from the drop-down list. If undecided or unknown at this
time, please select the "Undecided" option.
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Telephone:
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Assessment Center Telephone
This field indicates the telephone number that will be listed on the Florida
Ready to Work website for your Assessment Center. This is a required field.
The value for this field must be in the format ###-###-####.
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Telephone Extension:
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Assessment Center Telephone Extension
This field defines the extension of the Assessment Center telephone number.
This is an optional field. A valid value for this field is a number between
1 and 99999.
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Website:
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Assessment Center Website
This field indicates the URL of your Assessment Center's Web site. This is a
optional field. A valid value for this field is in the form of
www.floridareadytowork.com or http://www.floridareadytowork.com/.
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Primary Contact
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The Primary Contact is the person who is responsible for the implementation of the FRW program
and delivery of the FRW Assessments at this Assessment Center.
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Credential Delivery Information
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Delivered To:
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Credentials Delivered To
This field indicates whether the Credentials earned at your Assessment Center
should be delivered to the Credential Contact at the Assessment Center or to
the Participant's homes address.
*
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Credential Contact
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The Credential Contact is the person to whom the FRW Credentials will be mailed if
Credentials are NOT mailed to the student/jobseeker address.
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** If mail to student/jobseeker address is chosen, a Credential Contact is still
required in the case of an undeliverable student/jobseeker address or other Credential matter.
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Notes
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Please supply additional information here or include any questions you may have.
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Notes:
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Notes
This field indicates any additional notes about your potential Assessment Center setup.
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Click above to find an Assessment Center near you.
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To request more
information about
Florida Ready to Work
Click here!
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