University of Colorado Denver
School of Education & Human Development (SEHD)
Continuing and Professional Education Credit Application and Contract
This form is to be used by organizations external to the University of Colorado only. If the requester is an employee or department of
CU Denver, or if instructional pay is indicated, please contact the CPE office to obtain the appropriate forms.
Application Instructions: Please use this form to request university credit or continuing education units (CEUs) for your course or
event. Under this arrangement, the university pays no course-related expenses. Complete and sign this form, attach a course syllabus
and the instructor’s resume, and submit all materials to the SEHD Office of Continuing and Professional Education.
Today’s date:
Your name:
Your title:
Organization:
Address:
City
Phone:
State:
Zip:
Email address:
We will email the registration packet to you to share with course participants. We will also communicate with you regarding
submission of final grades after the course has ended. If someone else should receive the registration materials instead, please provide
that person’s name, email address, and phone number:
A. Course Information
Term (Summer/Fall/Spring):
Year:
Course Number:
Section:
(if known)
Course title:
Start date:
CPE use only
End date:
Instructional delivery method:
face-to-face
Meeting days (MTWRF):
online
self-paced
other (describe):
Meeting times:
Class location:
Number of contact hours:
Address:
City:
County:
State:
Zip:
Country:
Note that prior approval is REQUIRED when offering courses outside Colorado. Please allow 3 months to obtain approval.
If this is a Special Topics course (i.e., specific course title is not listed in the university catalog), enter the type of credit you are seeking:
Graduate credit
Undergraduate credit
Number of credits requested:
(1 credit per 15 contact hours)
Note: All courses offered for credit must be approved by the faculty as transferable into a University of Colorado Denver degree program.
Name of degree program, if known:
Continuing Education Units (CEUs)
Number of CEUs requested:
(1 CEU per 10 contact hours)
Note: CEUs are not academic credit and are not transferable into any degree program. The university considers these “NON-CREDIT.”
B. Tuition Payment Information
Who is responsible for paying the participants’ tuition?
Individual participants
Other (please explain):
C. Instructor Information
1. Instructor name:
Phone:
Email:
2. Have you been in contact with any faculty or staff at the School of Education & Human Development with regard to this course/event?
Yes. I have been in contact with:
No. This is my first contact.
CU Denver School of Education and Human Development • Continuing and Professional Education
999 Eighteenth Street • Suite 144 • Denver, CO 80202
voice: 720.639.9229 • email: cpe@ucdenver.edu
D. Contract
AGREEMENT FOR UNIVERSITY CREDIT CONTRACT
THIS CONTRACT is between [name of contractee] hereinafter referred to as “Course Provider” and the Regents of the University of Colorado, a body corporate, for
and on behalf of the University of Colorado Denver School of Education and Human Development, Continuing and Professional Education, hereinafter referred to as
"UC Denver." As a representative of the contracting organization or institution, Course Provider agrees to the following:
1) Course Provider will assume all costs associated with the contracted instruction and provide all services associated with the instruction (e.g., teaching, registration,
classroom/location, etc.). UC Denver is responsible only for assuring course content by reviewing course syllabi and Course Provider curriculum vitae, awarding
[credit or CEUs], providing a transcript to the student upon successful completion of the course, collecting tuition payments, and the student’s request. Course
Provider must inform students enrolled in the course that the credits are CEUs or academic credits available for transfer.
2)
Course Provider will not establish a tuition rate above that established by UC Denver and agrees to abide by UC Denver’s registration deadlines and requirements.
3)
Course Provider will be responsible for quality control in teaching the course and providing the course in accord with the syllabi and information provided to UC
Denver.
4)
Course Provider hereby agrees to indemnify and hold UC Denver, its agents, officers, and employees, harmless from any liability arising out of use of its facilities
or related to any activities that may arise from obligations created by this Agreement including but not limited to personal injury, property damage, court costs,
and attorney fees.
5)
UC Denver shall have no liability except as set forth in this Agreement.
6)
Nothing in this Agreement shall be construed or interpreted as a waiver, express or implied of any of the immunities rights, benefits, protections, or any other
provision of the Colorado Governmental Immunity Act, § 24-10-101, et seq. C.R.S., as now or hereafter amended. The parties understand and agree that liability
for claims for injuries to persons or property arising out of negligence of the State of Colorado, its departments, institutions, agencies, boards, officials, and
employee is controlled and limited to the provision for § 24-30-101 et seq., C.R.S., as now or hereafter amended and the risk management statutes, § 24-30-1501
et seq., C.R.S., as now or hereafter amended.
7)
This Agreement shall be effective as of
(date)
and continue in full force and effect until (date)
. Either party may terminate this
Agreement for any reason by providing the other party at least 30 days written notice prior to the effective date of termination. Termination of this Agreement
shall not affect the rights and obligations of the parties which shall have accrued prior to termination.
8)
Course Provider may provide information to potential students that the course/event as detailed in Section A of Application of Credit Request Form may be
eligible for (CEUs/credit) from UC Denver. Course Provider agrees that it will not state or imply that UC Denver sponsors, supports, or endorses the Course
Provider in any publication or website. Course provider may not advertise the course/event other than as provided unless Course Provider receives consent from
UC Denver in writing. If the course/event has been approved for (CEUs/credit) by UC Denver, Course Provider will instruct students enrolled in the course/event
that (CEUs/credit) may be available for those students who successfully complete the course/event. Course Provider will instruct students regarding whether the
(CEUs/credits) are transcribed as graduate or master’s level credits or as CEUs. Course Provider shall instruct students wishing to receive (CEUs/credits) to
register and pay for these units according to instructions provided by UC Denver.
9)
Course Provider agrees not to use UC Denver’s name, logos, or marks in any advertising or other publications without prior written approval from UC Denver.
Additionally, any approved use of UC Denver’s name will not imply any endorsement, sponsorship, or support of the Course Provider’s product.
10) Each party is an independent contractor, and this Agreement shall not be construed as creating a partnership, joint venture or employment relationship between the
parties or as creating any other form of legal association that would impose liability on one party for the act or failure to act of the other party, other than as stated
herein.
11) This Agreement shall be construed by the laws of the State of Colorado, without regard to conflict of laws principles. Course Provider agrees to comply with all
applicable federal, state, and municipal laws and regulations in performing its duties under this Agreement including treating any student records or student
information in accord with the Family Educational Privacy Act.
12) This Agreement may be amended upon the written mutual consent of the parties; such consent will not be unreasonably withheld.
13) This Agreement constitutes the entire understanding between the parties and all other prior negotiations, representations and understandings are superseded
hereby. Neither party was induced to enter into this Agreement by any statements or representations not contained in this Agreement. Neither party shall have any
authority, nor shall either party represent that it has any authority, to assume or create any obligation, express or implied, on behalf of the other party, except as
provided in this Agreement.
The waiver of any term or condition of this Agreement by either party shall not be deemed a waiver of any other term or condition of this Agreement.
IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed as of the date set forth herein by their duly authorized representatives
REGENTS OF THE UNIVERSITY OF COLORADO
(CLICK HERE AND INSERT CONTRACTEE’S LEGAL NAME)
By:
____________________________________
By:
____________________________________
Name:
Hilary Bruce__________________________
Name:
___________________________________
Title:
Assistant Director of CPE________________
Title:
____________________________________
Date:
____________________________________
Date:
____________________________________
Federal I.D. Number: 84-6000555
ACKNOWLEDGED AND AGREED BY:
SCHOOL OF EDUCATION AND HUMAN DEVELOPMENT, CONTINUING AND PROFESSIONAL EDUCATION
By:
____________________________________
Name:
Hilary Bruce__________________________
Title:
Assistant Director of CPE________________
Date: