Requesting CEU Sponsorship
This form is used for Organizational Members of NCRID who would like NCRID to sponsor CEUs for your workshop.
Sign in to Google to save your progress. Learn more
Your Full Name & Your Organization's Name *
Your Email Address *
Name of Workshop/Activity *
Date Workshop/Activity will Begin *
MM
/
DD
/
YYYY
Date Workshop/Activity will End *
MM
/
DD
/
YYYY
Location of Activity (physical address if in person) *
Start Time *
Time
:
End Time *
Time
:
Number of CEUs  *
Target Audience *
Participant's Prior Knowledge of Topic Required *
Content Area for CEUs *
Does this workshop meet the requirements for Power, Privilege, and Oppression (PPO)? *
Name of Presenter(s) *
Please include the presenters' biography, resume, or CV here. *
Workshop Description *
Educational Objective 1 *
Educational Objective 2 *
Educational Objective 3 *
Educational Objective 4
Educational Objective 5
What materials will you use for this presentation/workshop? (Includes physical material items and handouts, PowerPoint, etc.) Please also include who will provide these materials. *
Describe the evaluation/assessment process and tools you will use. The student learning and presentation effectiveness must be evaluated. *After submitting this form, you will be asked to email the evaluation form participants are required to complete * *
Who should interested individuals contact with questions? *
Contact Phone Number *
Contact Email *
Website (if applicable)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms