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Continuing Education Program CEU Program/Activity Application
Instructions
Complete each item on the form
Submit at least 30 days prior to planned program/activity
Send vitae via email attachment to
knstevenson@mail.ecsu.edu
for each instructor.
School
Arts & Humanities
Business & Economics
Education & Psychology
Math, Science & Techology
Military Science
Department
Department of Accounting
Department of Art
Department of Biology
Department of Business Administration
Department of Chemistry, Geology & Physics
Department of Education
Department of Health & Physical Education
Department of History & Political Science
Department of Language, Literature & Communication
Department of Mathematics & Computer Science
Department of Music
Department of Pharmacy & Health Professions
Department of Psychology
Department of Social Sciences
Department of Technology
Program/Activity Sponsor
First Name
Last Name
Phone Number
Email Address
Co-Sponsors
First Name
Last Name
Course Instructors
First Name
Last Name
Program/Activity Title
Course number
Course section
Program/Activity Start Date
Program/Activity End Date
Location of Activity
Off Campus
On Campus
Program/Activity Format
Course
Short Course
Conference
Institute
Workshop
Other
Description of Activity
(Please limit description to 4000 characters.)
Evaluation Procedure
(Please limit procedure to 4000 characters.)
Anticipated Attendance
Program/Activity Contact Hours
CEU's Requested
(1 CEU is awarded for each 10 contact hours of participation)
Comments
(Please limit comments to 4000 characters.)
The Program/Activity Form will be sent electronically via email to your Dean for Approval upon your submission of this form.
