CEU Request

APWA chapters may receive permission to award CEUs for chapter-sponsored events/activities when events/activities meet the following criteria:

The event/activity must be planned in response to educational needs which have been identified for a target audience.
Participants must take part in a group event/activity. CEU may not be awarded for individual or self-directed study that is not planned, directed and supervised by an instructor or sponsor.
The event/activity must have clear, concise written statements of intended learning outcomes, which convey to participants exactly what they are expected to accomplish.
Qualified instructional personnel must be involved in planning and conducting each event/activity. Instructors and facilitators should have competence in the subject matter, understanding of the purpose and intended learning outcomes of the activity, and the ability to communicate effectively with their audience.
Participants must demonstrate that they have achieved the learning outcomes. This may be done in many ways: questions and answers; discussions, summaries, case studies; demonstrations or simulations; written or oral examinations; written exercises or reports.
Upon completion, the participants must evaluate each learning activity. Participant evaluations should measure the overall quality and effectiveness of the learning activity.

Upon approval of this CEU request, the chapter will be sent complete instructions on how participants can apply for CEUs, the necessary "CEU Request Forms," and validation stickers.

Instructions:

Please type all information. Complete a separate form for each event/activity you wish to be considered for permission to award CEU.

Sponsoring Chapter:_______________________________________

Title of Event/Activity:______________________________________

Scheduled date:___________________________________________

Duration (submit detailed agenda as appropriate):__________________

Description of event/activity and defined purpose:___________________
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Target Audience:________________________________________
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List instructors/facilitators and submit professional bios for each (attach additional sheet as needed):

Name:_____________________
Title:______________________
Agency/Corp:_______________
Address:___________________
City:______________________
State/Zip:__________________
Phone:____________________ Name:_____________________
Title:______________________
Agency/Corp:_______________
Address:___________________
City:______________________
State/Zip:__________________
Phone:____________________

Learning Objectives:____________________________________
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How will participants demonstrate that they have achieved the learning objectives? (Submit copy of questions, examination, discussion outline, etc. as appropriate)___
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How will participants evaluate the event/activity?
(Submit example of evaluation tool that will be used)

How will the chapter use the information obtained through the evaluations?________________________________________________________
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This form was completed by:

Name:___________________________________________________
Title:____________________________________________________
Address:_________________________________________________
City:______________________________ State:_________________
Zip:________________
Phone:_____________________________
Fax:_______________________________

Staff Contact: kwilson@apwa.net