This document contains three pages: this page of instructions and two copies of your certificate.

If your name is incorrect on your certificate, or if you have changed your name since registering, please
contact us by email at help@violenceworkshop.com and we will update your name. You cannot change your
name yourself.

If you work or volunteer in any field related to education, your workshop completion must be must
submitted to TEACH electronically, as they no longer accept paper certificates. If you have not yet
requested to have your certificate submitted to TEACH, please log in to our website again and follow the
on-screen instructions.
If you requested that your course be submitted to TEACH, and your TEACH account is not updated
within one week, please follow the instructions at www.violenceworkshop.com/teach to resolve.

For all licensing NOT related to the Education professions:

You must print, sign, and mail your certificate to:

New York State Education Department, Division of Professional Licensing Services

[Type or Print the name of your profession]
89 Washington Avenue, Albany, NY 12234

If you have completed the workshop in Identification and Reporting of Child Abuse and Neglect, and are
not sure how to fill in sections 5 and 6, you may leave them blank. Do not return any documents to us.

Mandated workshops are not the only item required in order to secure employment and get certified or
licensed in your profession. The document that we provide must be submitted to New York State along
with, or following, an official State application in addition to other supporting documents. If, and only if,
you are certain that you have already submitted your professional application to the State, mail your
certificate to the State. If you need an application, wish to apply online, or are unsure what other
requirements you must fulfill, visit the State's website at www.nysed.gov or call them directly at
1-518-474-3901.

If you are required to take a state-mandated workshop, it is likely that you will be working with children in
some context. When faced with a situation or you suspect a wrongdoing, don't hesitate. Please remember
that the safety of children may be at stake and that you can make a difference and save lives!

WWW.VIOLENCEWORKSHOP.COM
WWW.CHILDABUSEWORKSHOP.COM
WWW.AUTISMAUTISM.COM

If you found our course instructive, we would appreciate if you referred other people to our website. You
will get $5 for each person you refer to our websites. Just make sure that they enter your email address as the
referral source when they register. Referrals are processed and sent within 8-12 weeks.
 The University of the State of New York
THE STATE EDUCATION DEPARTMENT

CERTIFICATION OF COMPLETION
TRAINING IN SCHOOL VIOLENCE PREVENTION AND INTERVENTION

PART A TRAINEE INFORMATION

This form is all that you need as proof that you have completed your mandated training. For all professions
which involve working in a school, your certificate will be sent electronically to the State and should
appear on your TEACH account within a week. This form is just one requirement for certification. Other
requirements include the application, transcripts, fingerprinting, and, in some cases, passing exams. For an
application and further details on certification, call 1 (518) 474-3901 or visit the New York State Education
Department at www.nysed.gov
1. Print name exactly as it currently appears on New York State Education Department Records.
Last Name: Tannacore
First Name: Nicholas
Middle Name/Initial: A
Organization:
2. Print your address:
Street: 65 Hale Rd
City: North Babylon
State: NY Zip Code: 11703
3. Date of Birth: 12/07/95
4. Social Security Number: ***-*4-1534

Trainee's Signature: Date:

PART B CERTIFICATION BY APPROVED TRAINING PROVIDER

1. Provider must complete Part B.
2. The EDUCATION DEPARTMENT - ORIGINAL COPY and TRAINEE COPY should be returned to the
trainee within 21 calendar days of the completion of coursework and training.
3. The provider of the coursework or training must retain the PROVIDER COPY. This copy must be retained
in the provider's files for not less than six years from the date the course was completed.
Pursuant to Chapter 181 of the Laws of 2000, I certify that the person indicated in Part A has completed the
required coursework or training in School Violence Prevention and Intervention.
Name of Authorized Certifying Officer
Approved Provider Name:
(Print or Type)
EMILY MCNULTY GENIUS GENIUS OF NY, INC.

Signature of Authorized Certifying Officer: Identification Number:

0090
Date(s) of Coursework or Training
08/06/2018

Certificate #: 247217
 The University of the State of New York
THE STATE EDUCATION DEPARTMENT

CERTIFICATION OF COMPLETION
TRAINING IN SCHOOL VIOLENCE PREVENTION AND INTERVENTION

PART A TRAINEE INFORMATION

This form is all that you need as proof that you have completed your mandated training. For all professions
which involve working in a school, your certificate will be sent electronically to the State and should
appear on your TEACH account within a week. This form is just one requirement for certification. Other
requirements include the application, transcripts, fingerprinting, and, in some cases, passing exams. For an
application and further details on certification, call 1 (518) 474-3901 or visit the New York State Education
Department at www.nysed.gov
1. Print name exactly as it currently appears on New York State Education Department Records.
Last Name: Tannacore
First Name: Nicholas
Middle Name/Initial: A
Organization:
2. Print your address:
Street: 65 Hale Rd
City: North Babylon
State: NY Zip Code: 11703
3. Date of Birth: 12/07/95
4. Social Security Number: ***-*4-1534

Trainee's Signature: Date:

PART B CERTIFICATION BY APPROVED TRAINING PROVIDER

1. Provider must complete Part B.
2. The EDUCATION DEPARTMENT - ORIGINAL COPY and TRAINEE COPY should be returned to the
trainee within 21 calendar days of the completion of coursework and training.
3. The provider of the coursework or training must retain the PROVIDER COPY. This copy must be retained
in the provider's files for not less than six years from the date the course was completed.
Pursuant to Chapter 181 of the Laws of 2000, I certify that the person indicated in Part A has completed the
required coursework or training in School Violence Prevention and Intervention.
Name of Authorized Certifying Officer
Approved Provider Name:
(Print or Type)
EMILY MCNULTY GENIUS GENIUS OF NY, INC.

Signature of Authorized Certifying Officer: Identification Number:

0090
Date(s) of Coursework or Training
08/06/2018

Certificate #: 247217