ESD 105 Proof of Completion Request Form
The Educational Service Districts of Washington are tasked with providing official documentation and proof of completion for all training under HB 1214 required for school safety and security staff.  

ESD's will provide certificates ONLY for their own region.  If you are serving schools in another ESD, please contact your Comprehensive School Safety Coordinator directly (contact information provided on the S5 Website).

When you feel you have completed ALL requirements (see instructions in the Participant Guide and/or S5 Website), please complete and submit this form.

Once the form is submitted, a representative from ESD 105 will contact you to finish the process.

Thank you for all you do to safeguard our schools!
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Email *
First Name *
Last Name *
School District Served *
ESD 105 School Districts ONLY
Completed Steps
Steps may be completed and submitted individually or all together.

All steps must be completed before final Proof of Completion certificate can be issued.  

You will be asked to provide the appropriate Proof of Completion form (Appendix A, B or C from your Participant Guide), completed and signed, for verification of each step.
Classroom Training *
Units 1-13 (in person or virtual)
On-the-Job Training *
2 days minimum
Check-ins (non-SRO's only) *
6 check-ins
Additional Comments
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