CEU Evaluation Request Form

If your CEU course has not been pre-approved, please fill out the below form for our committee to review.

Email(Required)

Name(Required)

First Last

CPRM #(Required)

Phone(Required)

Event Title(Required)

Event Date(Required)

Event Length (in hours)(Required)

Provide a brief description of the event:(Required)

Event Location(Required)

Number of CEUs Requested(Required)

Up to 16 CEUs can be approved for 1 event. Number requested will not always be approved.

Event Agenda or Schedule(Required)

Max. file size: 300 MB.