Request Form for Offering Continuing Education Units for Events
To be submitted by a VA Conference Board, Agency, or District- Board of Ordained Ministry, Virginia Annual Conference, The United Methodist Church
Event Title
*
Date(s) of Event
*
Sponsoring Organization(s)
*
Event Coordinator/Registrar
*
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Brief Description of Event
*
Include event objectives and event format.
Which "characteristics" in the Characteristics for Effective Clergy does this event address?
*
Include event objectives and format.
List Instructor(s)
*
Briefly denote professional qualifications/agency affiliations.
Back
Next
If the event has a web page, please provide the link:
If using other forms of communication, please attach here:
Browse Files
Drag and drop files here
Choose a file
Attach a copy of the brochure, schedule, agenda, etc.
Cancel
of
Event Location
*
Event Fee
*
Number of participants expected to attend
*
Number of instructional contact hours
*
[Refer to the Policy for Offering CEUs. If the event is to be held online, refer to the Adaptive Technology Document.]
An evaluation is required for all events granting CEUs. How will your event meet this requirement?
*
Name of person submitting this form (if not the Event Registrar)
Address of Submitter
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of Submitter
Please enter a valid phone number.
Email of submitter
*
example@example.com
Submit
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