Program Modification Request

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					                                                   TEXAS ALCOHOLIC BEVERAGE COMMISSION
                                               SELLER TRAINING PROGRAM MODIFICATION REQUEST
FORM ST-406 (01/2011)

All schools must use the standard curriculum provided by TABC. Use Form ST-406, Program Modification Request, when
seeking approval for additional program content such as videos, quizzes, handouts, etc.

1. Submit a complete copy of the curriculum. Modifications must be printed in bold and in the exact location in the
curriculum in which they will be taught. These copies must be indexed so that the specific points of change are
readily identifiable.

2. Include a revised timeline to show where the additional content will be taught and how much time is being added
to the program for each modification.

Mail completed request plus required materials to:

                                             ATTN: SELLER-SERVER CERTIFICATION
                                           TEXAS ALCOHOLIC BEVERAGE COMMISSION
                                                        P O BOX 13127
                                                   AUSTIN TEXAS 78711-3127

                                                          (PRINT OR TYPE)

SCHOOL NAME:                                                                      SCHOOL NUMBER:                      -
EMAIL:                                                          BUSINESS PHONE:                   (       )       -
CITY:                                                            STATE:                 ZIP CODE:
CONTACT PERSON:                                                             PHONE NO.:        (       )       -
Provide description of program modification for which approval is sought. (Attach additional sheets if needed):

Reason for modification:

Submitted by:                                                               Approved by:

                        Authorized Signature for School                              Authorized TABC Signature

                                Request Date                                                Date Approved

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