STATE OF CALIFORNIA DEPARTMENT OF CALIFORNIA HIGHWAY PATROL

DRUG EVALUATION AND CLASSIFICATION PROGRAM: CLASS NOTIFICATION CHP 523 (New 6-19) OPI 066

Chp523_0519.pdf

Upon completion, send this form to the California Highway Patrol (CHP) Drug Evaluation and Classification Program (DECP) via e-mail at dre@chp.ca.gov. Once the class has been approved, a Commission on Peace Officer Standards and Training (POST) course certification number will be sent to the coordinator. Upon completion of the class, the coordinator is required to submit a completed roster of students to the CHP DECP within five days.

CLASS COORDINATOR INFORMATIONCOORDINATOR'S NAME (Last, First) AGENCY NAME

COORDINATOR'S E-MAIL ADDRESS

COORDINATOR'S WORK NUMBER COORDINATOR'S CELL NUMBER COORDINATOR'S FAX NUMBER

CLASS INFORMATION

DRUG RECOGNITION EVALUATOR (DRE)

DRE RECERTIFICATION

DRE INSTRUCTOR DWI DETECTION SFST INSTRUCTOR

DUI DETECTION / STANDARDIZED FIELD SOBRIETY TESTING (SFST)

DRUG IMPAIRMENT TRAINING FOR EDUCATIONAL PROFESSIONALS (DITEP)

ADVANCED ROADSIDE IMPAIRED DRIVING

ENFORCEMENT (ARIDE)

CLASS DATE CLASS START/END TIMES MAXIMUM NUMBER OF STUDENTS

CLASS LOCATION / ADDRESS (INCLUDE BUILDING / ROOM NAME OR NUMBER)

FOR SFST ONLY:

WILL THE CLASS INCLUDE AN ALCOHOL WORKSHOP?YES NO

IF YES, PROVIDE LOCATION, INCLUDING STREET ADDRESS FOR THE WORKSHOP

IS THERE A CLASS FEE? YES NOIF YES, PROVIDE THE AMOUNT

LIST ALL INSTRUCTORS (MUST HAVE A POST RESUME ON FILE WITH THE CHP DECP)

FOR CHP DECP USE ONLY

APPROVEDAUTHORIZED SIGNATURE

DENIED

DATE

REASON FOR DENIAL

POST COURSE CERTIFICATION NUMBER ENTERED IN POST BY (INITIALS)

FOR DITEP ONLY:

IS THIS CLASS OPEN TO PERSONNEL FROM ALL SCHOOLS / DISTRICTS?YES NO

FOR CHP DECP USE ONLY