Level course application 2026

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  1. Click ‘Get Form’ to open the level course application in the editor.
  2. Begin by entering the 'COURSE TITLE', 'CODE', and 'HOURS' in the designated fields. Ensure that these details accurately reflect your course information.
  3. Fill in the 'STARTING DATE', 'ENDING DATE', 'STARTING TIME', and 'ENDING TIME'. If there are additional meeting dates or times, indicate them clearly in the provided section.
  4. Provide the local contact person's name and address, along with the course location including street, city, state, and zip code.
  5. Complete the contact information fields for telephone (day and night), email, fax, and county.
  6. Indicate whether DOH Con-Ed Registration is requested by checking 'Yes' or 'No'.
  7. Enter the name and address of the proposed instructor. Confirm if they have been contacted by marking 'YES' or 'NO'.
  8. Finally, ensure that a representative from your agency signs and dates the form to attest to insurance coverage for participants.

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