Continuing Education Agency Application

Continuing Education Agency Application

Address(Required)
Name:(Required)
Is there usually a charge for trainings?(Required)
Are attendees provided a certificate after the training?(Required)
(Certificates must include agency name, seminar title & date, attendees name, number of contact hours, and an authorized signature)
The number of trainings is an estimate for the year. If your agency does less than paid for, no refunds will be given. If you go above the number of approved trainings, the additional fee will be due at such point.
Price: $100.00
Please Return This Application With The Appropriate Fee:(Required)
The number of trainings is an estimate for the year. If your agency does less than paid for, no refunds will be given. If you go above the number of approved trainings, the additional fee will be due at such point.
Price: $0.00