Texas Court Clerks Association

Chapter Name:

Chapter President First Name:

Chapter President Last Name:

Contact Name:

Contact Person's Email Address:

Accredited Event Requested: Testing - Level I, Level II, & Level III

Special Certification Testing Site Sponsored by TCCA Local Chapter:

Proposed Testing Date:

Proposed Testing Site:

Proposed Testing Site Address:

Test Proctor: (assigned by TCCA EDU Committee)__________________________

After you are Approved Checklist: Have you completed the following?:

• Contacted TMCEC with date of event
• Notified TCCA web chair
• Advertised your testing
• Obtained a minimum of 15 testing registrants
• Submit registrations, test fees, and proctor fee to the Certification Financial Manager
• It is required that you forward test attendance sheet after the completin of your testing

Electronic Signature (type your full name):

Dated (enter today's date):

You will received an email confirmation of your TCCA Chapter Sponsored Testing Site Application submission.