Online Form for EDITING AN EXISTING FACILITATOR in E-Track

Instructions for Completing this Online Form:

  1. Section One--all fields mandatory 
  2. Section Two--red fields mandatory, complete only those additional fields you want edited in the person's record
  3. NOTE: While all fields are not required, all fields are IMPORTANT.  Please UPDATE all fields that have changed for an individual.

SECTION ONE

Information on THE PERSON SUBMITTING THIS FORM (In case we have follow-up questions on the information you enter below):

YOUR Name: *  
YOUR Phone #: *  
YOUR Email: *  

NOTE: This section must be completed, even if it is duplicative of information listed below.


SECTION TWO

Information on the E-Track Facilitator Record to Be Edited--Red fields are required.  Complete all others that are new/updated information:

E-Track Login ID: *   As CURRENTLY in E-Track
Legal First Name: *   As CURRENTLY in E-Track
Legal Last Name: *   As CURRENTLY in E-Track
New Last Name:     To change E-Track last name
Middle Name:    
Trainer Category:   (NOTE: Select "Inactive" category if facilitator has retired, resigned, etc.)
Preferred First Name:   (e.g., nickname)
Mailing Address Line 1:    
Mailing Address Line 2:    
Mailing Address Line 3:    
City:    
State/Province:    
Postal Code:    
Country:    
Preferred Phone #:    
Fax #:    
Preferred Email:    
2-Digit Birth Month:    
2-Digit Birth Day:
Alternate Phone:    
Alternate Email:    
Bio Statement:   Use this field to add or replace a facilitator's bio statement in E-Track. Whatever is entered here REPLACES the current bio statement in E-Track.
Notes:   Use this field to add any additional clarification to the above information.

PLEASE ALLOW UP TO ONE BUSINESS DAY FOR FORM TO BE PROCESSED.

NOTE: To add to or edit a facilitator's list of certified learnings in E-Track, you will need to contact the appropriate IHS Trainer Development staff person: