Applicant Info Name(Required)
First
Middle
Last
Address(Required)
Course Info Choose course(Required) I acknowledge that I have completely read and fully understand the policies and guidelines outlined in the Protocol(Required) I will ensure that all participants have a CCN Email from Cornell University dated within 9 months of my scheduled Segment Two course date(Required) NOTE: Starting April 1, 2023 the Seafood HACCP Alliance protocol will require completion of a Segment Two training within 9 months of completing the Segment One course. Those enrolled after April 1, 2023 must meet this training requirement. For those enrolled prior to April 1, 2023, the previously recommended 6 months and no more than 2 years policy will be honored.
FAILURE TO ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTAND THE POLICIES OUTLINED WITHIN THE PROTOCOL WILL PREVENT YOU FROM BEING ABLE TO REGISTER A COURSE USING THIS FORM!
Course Time Zone(Required) Course Location(Required)
Explain why you will need to exceed the maximum allowed participants?(Required)
If course will be taught in a language other than English, list language:
This course is (choose one):(Required)
Trainers and Qualifying Credentials Attach brief vitae for all Assistant Trainers without an AFDO “current” certificate number.
Minimum of 1 qualified Trainer for every 8 participants and 1 technical administrator. Note: for classes over 8, the second qualified trainer can serve as technical administrator (list as both below, if applicable).
Attach brief vitae for all Assistant Trainers without an AFDO “current” certificate number.
Minimum of 1 qualified Trainer for every 10 participants and 1 technical administrator. Note: for classes over 10, the second qualified trainer can serve as technical administrator (list as both below, if applicable).
Attach brief vitae for all Assistant Trainers without an AFDO “current” certificate number. Required 2 trainers for more than 15 students.
How many CV or qualification documents would you like to upload? *Supervisory Trainer must be AFDO “qualified” according to the SHA/AFDO Seafood HACCP and SCP Training Protocol and be present for the duration of the course.
Supervisory Trainer(Required) (Only 1 Supervisory Trainer is allowed)
Technical Administrator(Required) (A maximum of 5 Technical Administrators are allowed)
Assistant Trainer (OPTIONAL) (A maximum of 20 Assistant Trainers are allowed)
I certify that I have taught at least 2 in-person Basic HACCP courses:(Required) The virtual training option is only available for instructors who have taught at least 2 in-person Basic HACCP courses (Section 3.8.1).
Please provide the following course specific details to verify your eligibility status:(Required)
AFDO Liaison (Optional — See Section 8.6 of the HACCP and SCP Training Protocol) I will be using the appropriate AFDO Affiliate to help facilitate my course:(Required) (i.e., registration, purchase manuals, and course certificates)
Choose which affiliate:
Course Agenda Attach a copy of the course agenda you will be using for this course. Course agenda must meet the requirements as outlined in the Protocol, Appendix I, II and III. Assure all topics are covered, and minimum contact times are met . Be advised the protocol and training manuals provide example agendas that may include a range of times. You will need to PROVIDE ACTUAL PROPOSED TIMES AND SHOW THAT THE COUSE IS A MINIMUM OF 16 CONTACT HOURS (HACCP) or 6.5 CONTACT HOURS (SCP AND SEGMENT II). NOTE: If you plan to teach the course agenda in less than the specified minimum contact hours you will need to justify your decision in writing before approval can be considered.
Attach a copy of the Agenda you will be using for this course. Course agenda must meet the requirements as outlined in the Protocol for SHA Virtual Basic HACCP Trainings. Assure all topics are covered, and minimum contact times are met by completing and submitting an SHA Hours Verification form . You will need to PROVIDE ACTUAL PROPOSED TIMES AND SHOW THAT THE COURSE IS A MINIMUM 16.5 CONTACT HOURS NOTE: If you plan to teach the course agenda in less than the specified minimum contact hours, you will need to justify your decision in writing before approval can be considered.
Attach a copy of the course agenda you will be using for this course. Course agenda must meet the requirements as outlined in the Protocol for SHA Virtual SCP Trainings. Assure all topics are covered, and minimum contact times are met. You will need to PROVIDE ACTUAL PROPOSED TIMES AND SHOW THAT THE COURSE IS A MINIMUM of 6.5 CONTACT HOURS. NOTE: If you plan to teach the course agenda in less than the specified minimum contact hours you will need to justify your decision in writing before approval can be considered.
Attach a copy of the course agenda you will be using for this course. Course agenda must meet the requirements as outlined in the Protocol for SHA Virtual Segment Two Trainings. Assure all topics are covered, and minimum contact times are met. You will need to PROVIDE ACTUAL PROPOSED TIMES AND SHOW THAT THE COURSE IS A MINIMUM 6.5 CONTACT HOURS. NOTE: If you plan to teach the course agenda in less than the specified minimum contact hours you will need to justify your decision in writing before approval can be considered.
How many 'Virtual' Course Agenda files would you like to attach?(Required) How many 'In-Person' Course Agenda files would you like to attach?(Required) I certify that the Course Agenda meets the topic requirements and satisfies the required Contact Hours(Required) Are you planning LESS than the required contact hours?(Required) Provide justification for why you are planning less than required contact hours:(Required)
How many 'SHA Hours Verification Sheet' files would you like to attach?(Required) Virtual Basic HACCP requirements acknowledgment:(Required) Yes, I certify that both the Course Agenda and SHA Hours Verification Excel Sheet meet the topic requirements and satisfy the required 16.5 Contact Hours.
In-Person Basic HACCP Requirements Acknowledgement:(Required) Yes, I certify that both the Course Agenda and SHA Hours Verification Excel Sheet meet the topic requirements and satisfy the required 16 Contact Hours.
Training Models Which approved Training Model(s) do you plan to use during your course?(Required) (Select all that apply)
Training Materials I certify that all training materials used are the approved SHA/AFDO Training Materials as outlined by the Protocols(Required) (i.e., including guides/manuals, slide sets, and training models)
Explain the answer provided above:(Required)
Explain why course is $0:(Required)
NOTE: The total cost per participant should be reasonable for necessary Trainer(s), travel, facilities, equipment, and related materials. If the cost per participant is over $600.00, please itemize below. The Alliance does not specify any specific limit for the cost per participant, but the course approval process can question any apparently excessive costs in order to encourage access to affordable education that advances seafood safety. All approved open courses with the respective costs per participant will be posted on Alliance maintained websites.
Itemized costs(Required) (A maximum of 10 are allowed)
Virtual Course Specific Questions Section 3.2 & 3.3 of the SHA Virtual Segment Two Training Protocol. Provide ample details for the following questions:
Section 3.2 & 3.3 of the SHA Virtual SCP Training Protocol. Provide ample details for the following questions.
Section 3.2 & 3.3 of the SHA Seafood HACCP Basic Virtual Training Course Protocol. Provide ample details for the following questions:
Explain how you will ensure video and audio is live and functional for all participants during the entire training:(Required)
How will you ensure interactions take place between Trainer and participants?(Required)
How will you ensure interactions take place between Participants and other Participants?(Required)
How will you ensure interactions take place between Participants and Course Materials?(Required)
(i.e. FDA Hazards Guide)
Will you ensure active participation through use of knowledge assessments and roll-call?(Required) If no, explain how will you ensure active participation and learning are taking place:(Required)
Explain how you will ensure participant attendance and visual contact throughout the training:(Required)
Section 3.5 of the SHA Virtual Segment Two Training Protocol
Explain how you will breakout participants for group work:(Required)
Explain how you will ensure all participants are participating in group activities:(Required)
Explain how participants will collaborate on developing the product description form, hazard analysis form, and HACCP plans:(Required)
Will a file sharing platform such as Google Documents be used?(Required) If no, explain how the product description form, hazard analysis form, and HACCP plans will be shared with participants:(Required)
Explain how group presentations will be conducted:(Required)
Course Evaluation (Section 3.7 of the SHA Seafood HACCP Basic Virtual Training Course Protocol) Virtual Basic HACCP Course Evaluation Acknowledgement(Required) Yes, I certify that the Course Evaluation contains the required questions as outlined in the SHA Seafood HACCP Basic Virtual Training Course Protocol
Explain how you will ensure each participant completes an evaluation:(Required)
Explain how you will submit your evaluations to AFDO at the completion of the course:(Required)
Course Evaluation (Section 3.7 of the SHA Virtual Segment Two Training Protocol) Virtual Segment II Course Evaluation Acknowledgement(Required) Yes, I certify that the Course Evaluation contains the required questions as outlined in the SHA Virtual Segment Two Training Protocol.
Explain how you will ensure each participant completes an evaluation:(Required)
Explain how you will submit your evaluations to AFDO at the completion of the course:(Required)
Miscellaneous Information Specify any additional information you would like to be included when the course is posted to the Upcoming Courses on the AFDO website:
(i.e. registration website, any cost differences, etc.)
Signature Signature of the applicant and/or Supervisory Trainer denotes agreement to conduct the described training in accordance with the SHA/AFDO Seafood HACCP and SCP Training Protocols and to be responsible for all fees.
Consent(Required) I acknowledge that the Seafood HACCP Alliance reserves the right to audit courses at any time and failure to follow the training Protocol may result in revocation of Trainer qualifications.
