Evaluation Request Form

I am requesting my performance be evaluated for certification purposes.

I confirm that I have successfully completed all steps and requirements outlined in the Instructor Certification Program prior to requesting a field evaluation.

Furthermore, I understand that granting my request is contingent upon evaluator availability and CVSA approval.

Additionally, I understand my presentation during my field evaluation may be captured via video and used by CVSA for evaluation and training purposes.

I am submitting this request at least 90 days prior to the start of the course.