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Core Online Enrollment Request

Enrollment form to be completed by supervisors. Fields marked with an * are required

  • Participant

  • Please enter your U Number. (Do not enter 00000)
  • Date Format: MM slash DD slash YYYY
  • (Specialist Information Only)
  • (Specialist Information Only)
  • (For Data Collection Purposes)
  • Please provide your specialist's home address. All CORE documents will be sent to their home prior to starting CORE.

  • Supervisor

  • District Director / Field Manager