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Click ‘Get Form’ to open it in the editor.
Begin by entering your organization’s name and mailing address in the designated fields. Ensure accuracy as this information is crucial for communication.
Provide contact details including a telephone number, fax number, and email address. This will facilitate any necessary follow-ups regarding your application.
Indicate whether any jurisdiction has denied or restricted your authorization to provide continuing education. If yes, provide detailed explanations in the space provided.
Complete the standards section by checking the appropriate box that describes your organization type and attach required documents such as charters and mission statements.
For learning activities, describe each planned course, including title, presenter details, content outline, and learning objectives. Attach any brochures if available.
Finally, review all sections for completeness before signing the affirmation at the end of the form. Ensure you include the $900 fee for processing.
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