Attachment 4: State Training Plan and Instructions

+-------------+-----+------+----------+-------+-------+------+------+
| **FY 2009   |     |      |          |       |       |      |      |
| STATE       |     |      |          |       |       |      |      |
| TRAINING    |     |      |          |       |       |      |      |
| PLAN**      |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| **State of  |     |      |          |       |       |      |      |
| \_\_\_\_\_\ |     |      |          |       |       |      |      |
| _\_\_\_\_\_ |     |      |          |       |       |      |      |
| \_\_\_\_\_\ |     |      |          |       |       |      |      |
| _\_\_\_\_\_ |     |      |          |       |       |      |      |
| Date:       |     |      |          |       |       |      |      |
| \_          |     |      |          |       |       |      |      |
| \_\_\_\_\_\ |     |      |          |       |       |      |      |
| _\_\_\_\_** |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| **^1^**     | *   | **^  | **^4^**  | **    | **    | **^  | **^  |
|             | *^2 | 3^** |          | ^5^** | ^6^** | 7^** | 8^** |
| **NTC**     | ^** |      | **NTC -  |       |       |      |      |
|             |     | *    | A        | *     | *     | **O  | **T  |
| **COURSE    | **  | *DES | ssociate | *ESTI | *ESTI | THER | OTAL |
| TITLE**     | NO. | IRED | Staff    | MATED | MATED | COS  | COS  |
|             | O   | LO   | Needed   | T     | PER   | TS** | TS** |
|             | F** | CATI | YES      | RAVEL | DIEM  |      |      |
|             |     | ON** | /NO**    | C     | CO    |      |      |
|             | **T |      |          | OST** | STS** |      |      |
|             | RAI |      |          |       |       |      |      |
|             | NEE |      |          |       |       |      |      |
|             | S** |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| Advanced    |     |      |          |       |       |      |      |
| NAS Level I |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| Advanced    |     |      |          |       |       |      |      |
| NAS Level I |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| Instructor  |     |      |          |       |       |      |      |
| Development |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| NAS -- Part |     |      |          |       |       |      |      |
| A (40       |     |      |          |       |       |      |      |
| hours)      |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| NAS - Part  |     |      |          |       |       |      |      |
| A           |     |      |          |       |       |      |      |
| Instructor  |     |      |          |       |       |      |      |
| Development |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| NAS - Part  |     |      |          |       |       |      |      |
| B (40       |     |      |          |       |       |      |      |
| hours)      |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| NAS -- Part |     |      |          |       |       |      |      |
| B           |     |      |          |       |       |      |      |
| Instructor  |     |      |          |       |       |      |      |
| Development |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| General     |     |      |          |       |       |      |      |
| Hazardous   |     |      |          |       |       |      |      |
| Materials   |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| General     |     |      |          |       |       |      |      |
| Hazardous   |     |      |          |       |       |      |      |
| Materials   |     |      |          |       |       |      |      |
| Instructor  |     |      |          |       |       |      |      |
| Development |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| **          |     |      |          |       |       |      |      |
| SUBTOTALS** |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+

+-------------+-----+------+----------+-------+-------+------+------+
| **FY 2009   |     |      |          |       |       |      |      |
| STATE       |     |      |          |       |       |      |      |
| TRAINING    |     |      |          |       |       |      |      |
| PLAN**      |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| **State of  |     |      |          |       |       |      |      |
| \_\_\_\_\_\ |     |      |          |       |       |      |      |
| _\_\_\_\_\_ |     |      |          |       |       |      |      |
| \_\_\_\_\_\ |     |      |          |       |       |      |      |
| _\_\_\_\_\_ |     |      |          |       |       |      |      |
| Date:       |     |      |          |       |       |      |      |
| \_          |     |      |          |       |       |      |      |
| \_\_\_\_\_\ |     |      |          |       |       |      |      |
| _\_\_\_\_** |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| **^1^**     | *   | **^  | **^4^**  | **    | **    | **^  | **^  |
|             | *^2 | 3^** |          | ^5^** | ^6^** | 7^** | 8^** |
| **NTC**     | ^** |      | **NTC -  |       |       |      |      |
|             |     | *    | A        | *     | *     | **O  | **T  |
| **COURSE    | **  | *DES | ssociate | *ESTI | *ESTI | THER | OTAL |
| TITLE**     | NO. | IRED | Staff    | MATED | MATED | COS  | COS  |
|             | O   | LO   | Needed   | T     | PER   | TS** | TS** |
|             | F** | CATI | YES      | RAVEL | DIEM  |      |      |
|             |     | ON** | /NO**    | C     | CO    |      |      |
|             | **T |      |          | OST** | STS** |      |      |
|             | RAI |      |          |       |       |      |      |
|             | NEE |      |          |       |       |      |      |
|             | S** |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| HM Security |     |      |          |       |       |      |      |
| (16 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| Cargo Tank  |     |      |          |       |       |      |      |
| Inspection  |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| (28 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| Cargo Tank  |     |      |          |       |       |      |      |
| Inspection  |     |      |          |       |       |      |      |
| Instructor  |     |      |          |       |       |      |      |
| Development |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| Other Bulk  |     |      |          |       |       |      |      |
| Packaging   |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| (28 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| Other Bulk  |     |      |          |       |       |      |      |
| Packaging   |     |      |          |       |       |      |      |
| Instructor  |     |      |          |       |       |      |      |
| Development |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| # SUBTOTALS |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+

+-------------+-----+------+----------+-------+-------+------+------+
| **FY 2009   |     |      |          |       |       |      |      |
| STATE       |     |      |          |       |       |      |      |
| TRAINING    |     |      |          |       |       |      |      |
| PLAN**      |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| **State of  |     |      |          |       |       |      |      |
| \_\_\_\_\_\ |     |      |          |       |       |      |      |
| _\_\_\_\_\_ |     |      |          |       |       |      |      |
| \_\_\_\_\_\ |     |      |          |       |       |      |      |
| _\_\_\_\_\_ |     |      |          |       |       |      |      |
| Date:       |     |      |          |       |       |      |      |
| \_          |     |      |          |       |       |      |      |
| \_\_\_\_\_\ |     |      |          |       |       |      |      |
| _\_\_\_\_** |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| **^1^**     | *   | **^  | **^4^**  | **    | **    | **^  | **^  |
|             | *^2 | 3^** |          | ^5^** | ^6^** | 7^** | 8^** |
| **NTC**     | ^** |      | **NTC -  |       |       |      |      |
|             |     | *    | A        | *     | *     | **O  | **T  |
| **COURSE    | **  | *DES | ssociate | *ESTI | *ESTI | THER | OTAL |
| TITLE**     | NO. | IRED | Staff    | MATED | MATED | C    | COS  |
|             | O   | LO   | Needed   | T     | PER   | OSTS | TS** |
|             | F** | CATI | YES      | RAVEL | DIEM  | \*** |      |
|             |     | ON** | /NO**    | C     | CO    |      |      |
|             | **T |      |          | OST** | STS** |      |      |
|             | RAI |      |          |       |       |      |      |
|             | NEE |      |          |       |       |      |      |
|             | S** |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| Compliance  |     |      |          |       |       |      |      |
| Review (CR) |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| (80 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| CR          |     |      |          |       |       |      |      |
| Instructor  |     |      |          |       |       |      |      |
| Development |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| New Entrant |     |      |          |       |       |      |      |
| Safety      |     |      |          |       |       |      |      |
| Audit (80   |     |      |          |       |       |      |      |
| hours)      |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| New Entrant |     |      |          |       |       |      |      |
| Safety      |     |      |          |       |       |      |      |
| Audit       |     |      |          |       |       |      |      |
| Workshop    |     |      |          |       |       |      |      |
| (16 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| New Entrant |     |      |          |       |       |      |      |
| Safety      |     |      |          |       |       |      |      |
| Audit       |     |      |          |       |       |      |      |
| Instructor  |     |      |          |       |       |      |      |
| Development |     |      |          |       |       |      |      |
| (40 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| Electronic  |     |      |          |       |       |      |      |
| On-Board    |     |      |          |       |       |      |      |
| Recording   |     |      |          |       |       |      |      |
| Devices     |     |      |          |       |       |      |      |
|             |     |      |          |       |       |      |      |
| (16 hours)  |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+
| **          |     |      |          |       |       |      |      |
| SUBTOTALS** |     |      |          |       |       |      |      |
+-------------+-----+------+----------+-------+-------+------+------+

+------------------+-----+------+-------+--------+--------+----+----+
| **FY 2009 STATE  |     |      |       |        |        |    |    |
| TRAINING PLAN**  |     |      |       |        |        |    |    |
|                  |     |      |       |        |        |    |    |
| **State of       |     |      |       |        |        |    |    |
| \_\_\_\_\_\_     |     |      |       |        |        |    |    |
| \_\_\_\_\_\_\_\_ |     |      |       |        |        |    |    |
| \_\_\_\_\_\_\_\_ |     |      |       |        |        |    |    |
| Date:            |     |      |       |        |        |    |    |
| \_\_\_\_         |     |      |       |        |        |    |    |
| \_\_\_\_\_\_\_** |     |      |       |        |        |    |    |
+------------------+-----+------+-------+--------+--------+----+----+
|                  | *   | **^  | **4** | *      | *      | *  | *  |
|                  | *^2 | 3^** |       | *^5^** | *^6^** | *^ | *^ |
|                  | ^** |      | **    |        |        | 7^ | 8^ |
|                  |     | *    | NTC - | **EST  | **EST  | ** | ** |
|                  | **  | *DES | Asso  | IMATED | IMATED |    |    |
|                  | NO. | IRED | ciate | TRAVEL | PER    | *  | *  |
|                  | O   | LO   | Staff | COST** | DIEM   | *O | *T |
|                  | F** | CATI | N     |        | C      | TH | OT |
|                  |     | ON** | eeded |        | OSTS** | ER | AL |
|                  | **T |      | YES   |        |        | C  | C  |
|                  | RAI |      | /NO** |        |        | OS | OS |
|                  | NEE |      |       |        |        | TS | TS |
|                  | S** |      |       |        |        | \* | ** |
|                  |     |      |       |        |        | ** |    |
+------------------+-----+------+-------+--------+--------+----+----+
| Passenger        |     |      |       |        |        |    |    |
| Vehicle          |     |      |       |        |        |    |    |
| Inspection       |     |      |       |        |        |    |    |
|                  |     |      |       |        |        |    |    |
| (40 hours)       |     |      |       |        |        |    |    |
+------------------+-----+------+-------+--------+--------+----+----+
| Passenger        |     |      |       |        |        |    |    |
| Vehicle          |     |      |       |        |        |    |    |
| Inspection       |     |      |       |        |        |    |    |
| Instructor       |     |      |       |        |        |    |    |
| Development (40  |     |      |       |        |        |    |    |
| hours)           |     |      |       |        |        |    |    |
+------------------+-----+------+-------+--------+--------+----+----+
| Skill            |     |      |       |        |        |    |    |
| Performance      |     |      |       |        |        |    |    |
| Evaluation       |     |      |       |        |        |    |    |
| Certification    |     |      |       |        |        |    |    |
| Program          |     |      |       |        |        |    |    |
|                  |     |      |       |        |        |    |    |
| (40 hours)       |     |      |       |        |        |    |    |
+------------------+-----+------+-------+--------+--------+----+----+
| CMV Safety       |     |      |       |        |        |    |    |
| Programs &       |     |      |       |        |        |    |    |
| Grants           |     |      |       |        |        |    |    |
| Management (40   |     |      |       |        |        |    |    |
| hours)           |     |      |       |        |        |    |    |
+------------------+-----+------+-------+--------+--------+----+----+
| Drug             |     |      |       |        |        |    |    |
| Interdiction     |     |      |       |        |        |    |    |
| Assistance       |     |      |       |        |        |    |    |
| Training (hours  |     |      |       |        |        |    |    |
| of training is   |     |      |       |        |        |    |    |
| negotiated based |     |      |       |        |        |    |    |
| on agency        |     |      |       |        |        |    |    |
| training needs)  |     |      |       |        |        |    |    |
+------------------+-----+------+-------+--------+--------+----+----+
| Preventing       |     |      |       |        |        |    |    |
| Discrimination   |     |      |       |        |        |    |    |
| in the           |     |      |       |        |        |    |    |
|                  |     |      |       |        |        |    |    |
| Fe               |     |      |       |        |        |    |    |
| derally-Assisted |     |      |       |        |        |    |    |
| Motor Carrier    |     |      |       |        |        |    |    |
|                  |     |      |       |        |        |    |    |
| Safety Programs  |     |      |       |        |        |    |    |
| (16 hours)       |     |      |       |        |        |    |    |
+------------------+-----+------+-------+--------+--------+----+----+
| # SUBTOTALS      |     |      |       |        |        |    |    |
+------------------+-----+------+-------+--------+--------+----+----+

**OTHER STATE TRAINING COURSES**

Please use this form to identify any other planned training not
sponsored by the FMCSA National Training Center, but funded by MCSAP.

As set forth in the Hazardous Materials Memorandum of Understanding
between the Research and Innovative Technology Administration (RITA),
Transportation Safety Institute (TSI) and FMCSA National Training
Center, specialized hazardous materials training is available through
TSI. For the limited number of State MCSAP officers/inspectors whose
responsibilities require more specialized and advanced hazardous
materials training, the costs of the specialized TSI courses are MCSAP
eligible expenses. At this time, TSIs specialized hazardous materials
training includes Explosives, Radioactive Materials, Cylinders,
Hazardous Waste/Substances, International Maritime Dangerous Goods
(IMDG), Infectious Substances and Performance Oriented Packaging (POP)
training courses. The need for this specialized hazardous materials
training should be identified in the Training Plan below and justified
in the CVSP.

+------------+------+------+----------+--------+--------+-----+-----+
| **FY 2009  |      |      |          |        |        |     |     |
| STATE      |      |      |          |        |        |     |     |
| TRAINING   |      |      |          |        |        |     |     |
| PLAN**     |      |      |          |        |        |     |     |
|            |      |      |          |        |        |     |     |
| **State of |      |      |          |        |        |     |     |
| \_\_       |      |      |          |        |        |     |     |
| \_\_\_\_\_ |      |      |          |        |        |     |     |
| \_\_\_\_\_ |      |      |          |        |        |     |     |
| \_\_\_\_\_ |      |      |          |        |        |     |     |
| \_\_\_\_\_ |      |      |          |        |        |     |     |
| Date:      |      |      |          |        |        |     |     |
| \_\_       |      |      |          |        |        |     |     |
| \_\_\_\_\_ |      |      |          |        |        |     |     |
| \_\_\_\_** |      |      |          |        |        |     |     |
+------------+------+------+----------+--------+--------+-----+-----+
| **^1^**    | **^  | **^  | **^4^**  | *      | *      | *   | *   |
|            | 2^** | 3^** |          | *^5^** | *^6^** | *^7 | *^8 |
| **COURSE   |      |      | **TSI    |        |        | ^** | ^** |
| TITL       | *    | *    | A        | **EST  | **EST  |     |     |
| E/VENDOR** | *NO. | *DES | SSOCIATE | IMATED | IMATED | *   | *   |
|            | OF** | IRED | STAFF    | TRAVEL | PER    | *OT | *TO |
|            |      | LO   | NEEDED   | COST** | DIEM   | HER | TAL |
|            | **TR | CATI | YES      |        | C      | C   | C   |
|            | AINE | ON** | /NO**    |        | OSTS** | OST | OST |
|            | ES** |      |          |        |        | S** | S** |
+------------+------+------+----------+--------+--------+-----+-----+
|            |      |      |          |        |        |     |     |
+------------+------+------+----------+--------+--------+-----+-----+
|            |      |      |          |        |        |     |     |
+------------+------+------+----------+--------+--------+-----+-----+
|            |      |      |          |        |        |     |     |
+------------+------+------+----------+--------+--------+-----+-----+
|            |      |      |          |        |        |     |     |
+------------+------+------+----------+--------+--------+-----+-----+
| **S        |      |      |          |        |        |     |     |
| UBTOTALS** |      |      |          |        |        |     |     |
+------------+------+------+----------+--------+--------+-----+-----+

(Use additional sheets if needed.)

**GRAND TOTAL OF TOTAL COSTS: \$ \_\_\_\_\_\_\_\_**

**STATE TRAINING FORM**

**PURPOSE**: States should include the State Training Plan as an
appendix to the CVSP. States should submit their best estimate for the
National Training Center (NTC) training needs. The State Training Plan
is used by the NTC to schedule and prioritize courses. While every
effort will be made to accommodate requested training, courses will be
approved based on available funding, and, the availability of
out-of-state Associate Staff Instructors if required. ***States should
be aware that first priority goes to scheduling classes requested
through the CVSP State Training Plan.***

**FORM INSTRUCTIONS**:

**Column 1:** Course provider, course title and number of course hours.

**Column 2:** Indicate the number of personnel you expect to train
during the fiscal year for each course listed.

**Column 3:** Identify the anticipated course location (i.e., whether
the course will be taken in-State, or in another State, or at a regional
training academy).

**Column 4:** Indicate whether you will need an instructor from the
National Training Center to instruct this course. If you have your own
in-state instructor(s), please answer no in this column.

**Column 5:** Estimate the total travel cost for personnel attending the
training course, taking into consideration the number of people to be
trained and the course location.

**Column 6:** Estimate the total cost of per diem (i.e., meals, lodging,
misc. expenses, etc.) for each course, taking into account the number of
students, days in the classroom and travel time to and from course site.

**Column 7:** Identify any other costs associated with each course
(i.e., classroom rental, equipment, etc.).

**Column 8**: Total the projected costs associated with each course
(columns 5 + 6 + 7), and at subtotal sum for all courses planned.
Recognizing that not all training is MCSAP funded, this projection
should equal the total amount budgeted for training in the CVSP.

In completing **page 5** of the State Training Plan under Column 1,
please identify planned training *not* sponsored by the NTC, including
course titles and vendors (i.e., specialized hazardous materials
courses, etc.). This should assist in planning all State training needs
to be funded through MCSAP and included in the CVSP.

Please be certain to see the instructions included at the top of page 5
of the State Training Plan related to specialized hazardous materials
training available through the Research and Innovative Technology
Administration's Transportation Safety Institute.

## 

## SCHEDULE INTAKE FORM

**PURPOSE:** The Schedule Intake Form (SIF) is the official document
States must submit when requesting approval for a course through the
National Training Center. A SIF is required only if a State is actually
going to schedule the course. A SIF must be completed for each course
scheduled.

**FORM INSTRUCTIONS**:

1.  List current Date

2.  Identify the name and title of person submitting completed form

3.  Identify course requested; a separate form is required for each
    course

4.  Identify course dates; a separate form is required for each course
    date

5.  Identify course location to include city, state and zip code

6.  Identify name and title of course contact

7.  Identify telephone number, cell phone number and email address for
    course contact

8.  Identify complete mailing address for course contact

9.  Identify complete shipping address for course materials; if
    alternate shipping location is required, please identify complete
    shipping address

10. Identify need and number of NTC Associate Staff Instructors; if
    "in-state" Associate Staff Instructors will be used, identify name
    of each

11. Identify total number of students scheduled to attend course; note,
    minimum class size is 10, maximum class size is 25

12. Identify if class is "open" to additional students or if class is
    "closed" to additional students

**SUBMISSION OF FORMS**:

Please complete the **State Training Form** and **Schedule Intake
Form(s)** and send along with your CVSP to the **Division Office**, who
in turn will forward the CVSP to FMCSA Headquarters and a copy of the
CVSP along with all completed Schedule Intake Forms for scheduled
courses, to the National Training Center (Attn: State Training Program
Manager). Questions concerning these training forms may be directed to
the NTC State Training Program Manager by calling (703) 235-0621. Please
note, you will be contacted by the NTC State Training Program Manager,
at least eight (8) weeks prior to the start of your class to confirm
instructor and materials availability.