Member Training - Katie Beckett Attestation Attention Employers of Record: If you represent more than one Member, please fill out an attestation for each of your Members. Fill out the form below and click submit. After you click submit, refresh the page and repeat for each Member.Employer of Record (EOR)/Representative NameEmployer of Record (EOR)/Representative Name(Required) First Last Member NameMember Name(Required) First Last Member CDTN Person IDMember CDTN Person ID Need help finding your CDTN Person ID?EOR/Representative EmailEOR/Representative Email(Required) EOR/Representative BirthdayEOR/Representative Birthday(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920EOR/Representative Last Four Digits of Social Security NumberEOR/Representative Last Four Digits of Social Security Number(Required) EOR/Representative CDTN Person IDHiddenEOR/Representative CDTN Person ID EOR/Representative Signature By signing, I attest that this training was completed solely by me. EOR/Representative Signature(Required)By submitting your information via this form, you agree to be contacted by CDCN via call, email, or text. To opt out, you can reply ‘stop’ at any time or click the unsubscribe link in the emails. For more information see our privacy policy. Message and data rates may apply. Consumer Direct Care Network Privacy Policy CAPTCHA