Class Interest Form

General Information

Agency: 

Address: 

Contact Person:        

Phone: 

Contact E-mail:                           

Program:  W-2        Child Care

Class Information

Class Requested (Title): 

Timeframe (specify dates or time period): 

Number of W-2/TANF participants from your agency: 

Additional Comments

Pressing the Submit button below will send the information to PTS.  You can expect a response within 3-5 business days.