Form Spb 810 Be PDF Details

Navigating the avenues of bilingual proficiency in the workplace often requires formal recognition and certification, and for employees within certain sectors, the State Personnel Board Oral Bilingual Proficiency Examination Request Form, known as the Spb 810 Be form, serves as a critical step in this process. Designed to facilitate requests for oral bilingual proficiency examinations, this form is an essential document for departments and individuals aiming to validate their employees' bilingual capabilities. The form outlines a structured method for exam requests, detailing necessary personal information, exam scheduling, and communication preferences, thereby ensuring that both the examining body and the participants are well-prepared for the examination process. Additionally, it clarifies the payment procedure, which must be completed prior to scheduling the exam, offering various methods including cashier’s checks, money orders, or credit card payments. Supervisor contact information is also requested to authenticate the identity of the test taker before the exam commences. This comprehensive approach not only streamlines the exam application process but also underscores the importance of linguistic proficiency in enhancing service delivery within bilingual communities.

QuestionAnswer
Form NameForm Spb 810 Be
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesSPB_810 BE state personnel board oral bilingual examination request form

Form Preview Example

State Personnel Board

Oral Bilingual Proficiency Examination Request Form

Bilingual Services Program (BSP)

EXAM REQUEST 1:

LAST NAME

FIRST NAME

WORK PHONE NUMBER

MAILING ADDRESS (for Exam Results)

Address:

City:

State:

Zip Code:

CONFIRM EXAM DATE & TIME TO EMPLOYEE BY: LANGUAGE EXAM: E-Mail Address:

or

Fax Number:

EXAM REQUEST 2:

LAST NAME

 

FIRST NAME

 

 

 

WORK PHONE NUMBER

 

 

 

 

 

 

 

 

 

 

Ext.

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS (for Exam Results)

 

 

CONFIRM EXAM DATE & TIME TO EMPLOYEE BY:

LANGUAGE EXAM:

Address:

 

 

 

 

E-Mail Address:

 

 

 

 

 

 

 

 

 

or

 

 

 

City:

State:

Zip Code:

Fax Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EXAM REQUEST 3:

 

 

 

 

 

 

 

 

 

LAST NAME

 

FIRST NAME

 

 

 

WORK PHONE NUMBER

 

 

 

 

 

 

 

 

 

 

Ext.

 

 

 

 

 

 

 

 

 

MAILING ADDRESS (for Exam Results)

 

 

CONFIRM EXAM DATE & TIME TO EMPLOYEE BY:

LANGUAGE EXAM:

Address:

 

 

 

 

E-Mail Address:

 

 

 

 

 

 

 

 

 

or

 

 

 

City:

State:

Zip Code:

Fax Number:

 

 

 

 

 

 

 

 

 

 

 

 

SUPERVISOR’S CONTACT INFORMATION:

 

 

 

 

 

 

 

NAME:

 

 

 

 

 

TITLE:

 

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS (for Exam Results)

 

 

CONTACT NUMBER1:

 

Ext.

 

Department:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

ALTERNATE NUMBER:

 

Ext.

 

City:

State:

Zip Code:

 

 

 

 

 

 

 

 

 

 

 

 

CONFIRM EXAM DATE & TIME TO SUPERVISOR BY:

 

 

 

 

 

 

E-Mail Address:

 

 

 

 

or Fax Number:

 

 

 

 

 

 

 

 

 

 

 

REASONABLE ACCOMMODATIONS (Please Specify):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EXAM REQUESTED BY:

 

 

 

 

 

 

 

 

 

REQUESTOR’S NAME:

 

 

 

TITLE:

 

 

TELEPHONE NUMBER:

 

 

 

 

 

 

 

 

 

 

 

Ext.

 

 

 

 

 

 

 

 

 

 

 

1The employee’s supervisor must be available at the listed contact number to verify the identity of the employee being tested, prior to starting the examination. If the supervisor and candidate are to be reached at a different number than the contact number, please list as an alternative number. In addition, if we are unable to reach you within 15 minutes of the scheduled start time of the exam the candidate will need to reschedule.

SPB-810-BE

- 1 -

Rev. 1//2008

State Personnel Board

Oral Bilingual Proficiency Examination Request Form

Bilingual Services Program (BSP)

PAYMENT IS DUE PRIOR TO EXAM BEING SCHEDULED (NO CASH OR PERSONAL CHECKS CAN BE ACCEPTED)

PAYMENT METHOD:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mail Payment & Request Form To:

 

$115.00/ea. - Purchase/Service Order #____________(Attached)

 

 

 

 

*

 

 

 

 

 

SPB – Bilingual Services Program

 

$115.00/ea. - Bill Consolidated Contract #_______________*

 

 

 

Attn: Bilingual Testing Coordinator

 

 

 

 

 

 

 

 

$115.00/ea. – Cashier’s Check or Money Order Enclosed

 

801 Capitol Mall, MS #64

 

 

Sacramento, CA 95814

 

(Payable to State Personnel Board)

 

 

 

 

 

 

 

 

$115.00/ea – Cal Card or Credit Card*

 

For Information or Questions:

 

 

 

 

 

 

 

 

 

 

 

 

 

(916) 651-9017 or TTY (916) 651-8782

 

_______________ x $_______________ = $____________

 

Fax: (916) 651-7840

 

# of Exams

Cost Per Exam

Total Cost

 

 

 

 

 

 

 

 

 

 

 

 

 

*IF PAYING BY CONSOLIDATED CONTRACT OR PURCHASE/SERVICE ORDER, PLEASE INCLUDE THE FOLLOWING INFORMATION.

Name of person to invoice:

 

 

 

Unit:

 

 

Address:

 

 

City

 

State:

Zip Code:

Phone number:

 

 

 

 

Fax number:

 

 

 

 

 

 

 

 

 

 

 

*IF PAYING BY CREDIT CARD/CAL CARD:

 

 

 

 

 

 

Name of the Candidate(s) for which this payment should be applied:

 

 

 

 

 

 

 

 

 

 

 

 

1.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number of Exams

 

 

Item Description

 

 

Cost Per Item

 

Total Cost to be Charged

 

 

 

 

Bilingual Oral Fluency

 

$115.00

 

 

 

 

 

 

 

Examination

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Credit Card Information

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Card Holder (as it appears on the credit card):

Type of Credit Card:

Cal Card

 

 

 

 

 

 

Credit Card #:

 

Expiration Date:

 

 

 

 

Mailing Address (to send receipt):

 

 

Address:

City:

State:

Zip:

Contact Telephone Number:

I Hereby Authorize the State Personnel Board to charge my credit card for the total cost of administering the above bilingual oral fluency exam(s).

Signature of Card Holder:

THE EMPLOYEE AND SUPERVISOR WILL RECEIVE CONFIRMATION BY E-MAIL OR FAX, APPROXIMATELY 7 DAYS

FROM THE DATE THE EXAMINATION IS SCHEDULED.

NO EXAMINATION WILL BE SCHEDULED UNTIL THE CHECK OR PAYMENT AUTHORIZATION IS RECEIVED.

I hereby certify that I am authorized to submit a request for bilingual fluency examination, as or on behalf of, the department’s testing officer.

Signed:

Title:

Date:

SPB-810-BE

- 2 -

Rev. 1//2008

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