NOTE: Please provide all pertinent information relative to the course(s) you are seeking approval which will help expedite the course review process.
IMPORTANT: As a continuing education provider, you attest that as the course provider, you will maintain attendance records for the course(s) for one year after the date of this course.
You may submit your course application by US Mail or via Email (firstname.lastname@example.org). Please provide all supporting materials, including agenda with time schedule with application to minimize any delays in the approval process.
This form is for education providers only and cannot be used for individuals seeking continuing education credit.