EmailMeForm
CEU/Professional Development Hours Application
Organizations that wish to have the Center for Continuing and Professional Studies (CCPS) provide Continuing Education Units (CEUs) and/or Professional Development Hours (PDHs) for a specific Conference, Workshop, Institute, or Course, should use this form to submit a formal request.
Name
*
Prefix
First
MI
Last
Organization
*
Your Title
*
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Phone Number
*
###
-
###
-
####
Fax Number
###
-
###
-
####
Email Address
*
Which of the following are you proposing to offer?
*
Continuing Education Units
Professional Development Hours
Which of the following formats are you
proposing?
*
Conference
Course
Certificate Program
Workshop
Institute
Conference, Workshop, Institute, or Course Title
*
Date(s) of Event
*
ATTACHMENTS
Please upload a copy
of EACH presenter's
current CV or resume.
*
Add File
Your file MUST be in Microsoft Word or PDF format.
Please upload a copy
of the conference,
workshop, institute, or course booklet.
*
Your file MUST be in Microsoft Word or PDF format.
OFFICE USE ONLY
