ceu approval request form emmett
DESCRIPTION
Emmett Tree Care Workshop CEU's formTRANSCRIPT
Pacific Northwest Chapter of ISA PO Box 811Silverton OR 97381
CEU Approval Request Form
Effective July 1, 2004 503-874-8263 (phone)
503-/874-1509 (fax) [email protected] www.pnwisa.org
Individuals, organizations, and agencies wishing to obtain ISA Continuing Education Units (CEU’s) for conferences, courses, and workshops are asked to submit this form. To be approved, material presented must meet ISA recertification domains. Completed forms received at least two weeks prior to the event will be reviewed and listed at www.pnwisa.org.
Send this form and the agenda or attachments to PNW-ISA via email to [email protected]. Upon receipt of the completed form, PNW-ISA CEU volunteer coordinator will review materials, assign course code(s), and send CEU sign-in sheets to the program contact. Incomplete forms will be returned and may delay the review process. Forms received within the two week period before the program takes place will not be given CEUs you will have file a post approval form with ISA in Champaign Illinois
PROGRAM INFORMATION
Program/Course Title _Emmett Tree Workshop
Date(s) ___March 26, 2015_____________ Time(s) _9am – 4pm_____
Location ___Emmett City Hall501 East Main Street, Emmett, Idaho 83617 and Emmett City Park (across the street from City Hall)(include facility name, city, and state or province)
Sponsor(s) _West Central Highlands RC&D_____________________________CONTACT INFORMATIONName/Title _Gerry Bates_______________________________________Address__2445 John Adams Pkwy ________________________________________________________City/State/Zip or Postal code ___Idaho Falls, ID 83401____________________Phone __208-681-5964_____________________Alt Phone _______________________Fax __208-529-0832__________________ Email [email protected]_______________________
PROGARAM DESCRIPTION – Help us ensure an adequate review by providing complete information. Include speakers, topic details, program length, breaks/lunch scheduled, etc. Attach a copy of the agenda if available
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