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NC Department of Health and Human Services
DPH Environmental Health Section
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Centralized Intern Training and Authorization

CIT Registration

Please complete and submit the form below to request registration for a CIT class. You will be contacted by CIT staff regarding your request/submission to finalize enrollment or make alternate plans. Successful submission does not guarantee a spot in class.

Additional Requirements

In addition to submitting registration for CIT, you must review the distance learning materials for each track you will be attending. There is no pre-test nor post-test for Tier II (General Module). However, the General Module of CIT is required for all REHS Interns! There are pre-tests for the distance learning materials in the FPF Track and the OSWP Track. The pre-tests are given on the first day of class and they are closed-book.


CIT Registration Form
* Fields marked with an asterisk are required.
Date Submitted:

If you can see this field, leave it blank.
REHS Number:
REHS Intern Number:
Format: ###-###-####
Format: mm/dd/yyyy
* Gender:
* Supervisor:

Select at least one session. Complete CIT course details: 2018 CIT Training Schedule, 2019 CIT Training Schedule.

General:

Food:

OSWP:



* Authorization Area:

In what area will you be authorized?


You may enter up to 250 characters.
Characters remaining =
Specific Cross-Training:

If you are cross-training and attending only a specific portion, please indicate which one:


You may enter up to 250 characters.
Characters remaining =

You may enter up to 250 characters.
Characters remaining =
Emergency Contact Information
* Name:
* Relationship:
* Phone:

Please provide at least one emergency contact number for the person above. Format: ###-###-####

Home:

Work:

Cell:

 

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