Continuing Education Credit (CEU) Submission Form
Submit this form online for any activities or trainings you complete which are not
sponsored and/or facilitated by our program. If you receive a Certificate of Completion or Certificate of
Attendance, please be sure to include a copy. Four hours of credit will be given per book read and
up to two hours for film/video viewed. Determination of credit issued will be based on the thoroughness of
information provided in the Summary, Reflection, and Application sections (below).
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Email *
Date of Report: *
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Name: *
Email: *
Type of Training:
Title of Training:
Source of Training:
Summary:

Provide a detailed summary of the key points of the material, things you learned, points that stood out to you, etc.
Reflection:

In general, how does the information you gained from this activity relate to your work as a CASA volunteer?
Application:

Provide a brief example of how you might use the information you gained from this activity as a CASA assigned to a particular case.
Number of Credits (hours) Requested:
A copy of your responses will be emailed to the address you provided.
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