CEU Application Form - Lifelong Learning & Professional

advertisement
Continuing Education Units (CEUs)
APPLICATION AND APPROVAL PROCEDURES
Programs requesting CEUs from UNT must meet the following guidelines:
1. Sponsorship: UNT faculty must be involved in the planning, design, evaluation, and sponsorship of
the program. Activities co-sponsored with an off-campus group must have written approval of an
appropriate UNT faculty member for all program activities.
2. Application Deadline: The application form for CEUs must be received by UNT Lifelong Learning and
Professional Development (LLPD) no later than two weeks prior to the program OR prior to the
publication of any material stating CEUs are available (whichever date is earlier). Applications cannot
be accepted after an event begins.
3. Learning Objectives/Agenda: An hour-by-hour agenda or program must accompany this CEU
application. An agenda must include a statement of learning objectives (e.g., behavioral or
performance objectives) for each session/activity. For purposes of determining number of CEUs, the
agenda must clearly distinguish between instructional time and break, social, or administrative time.
Programs must include ways in which participants demonstrate the achievement of learning
outcomes (e.g., discussions, Q&A, case studies, simulations, exercises).
4. Brochure Copy: The program and registration form must be approved by LLPD before UNT CEUs are
advertised in the program’s brochure.
5. Faculty Credentials: A brief resume for each instructor and the sponsoring UNT faculty member
must accompany the CEU application. Full C.V.s are not necessary. We need only educational
degrees and experience relevant to the subject matter being taught.
6. Assessment: A description of the planned assessment must accompany the CEU application.
Assessments should measure the participants’ achievement of the learning objectives and evaluations
should ask participants to give feedback about the quality and effectiveness of the program, as well
as the degree to which the program helped them achieve the stated learning outcomes. Copies of the
completed evaluations (or a summary thereof) must be submitted to LLPD after the program is
completed.
7. Participant Records: After the program, original sign-in/sign-out attendance sheets must be turned
in to LLPD. Signature sheets should include or be accompanied by the typed name and address of
each participant. The UNT faculty sponsor must provide signed certification of all participants’
eligibility for CEUs (i.e., verify that all participants receiving CEUs attended the entire program OR
state the reduced number of CEUs that should be awarded).
8. CEU Certificates: Certificates will be issued only after the faculty sponsor and LLPD have verified that
the participants have successfully completed a program and after payment has been received for
database setup and individual certificates. No fee is charged to register the event for CEUs, but
individual certificates are $10 per person. Certificates will not be available at the program site unless
special arrangements have been made in advance and approved by LLPD. All required post-event
documents must be received by LLPD within three months after the program; after that, LLPD cannot
issue certificates (i.e., even participants who paid for certificates cannot receive CEUS and all
complaints must be referred to the UNT faculty sponsor).
Application for
Continuing Education Units (CEUs)
UNT Lifelong Learning and Professional Development
University of North Texas ◊ 1155 Union Circle #310560 ◊ Denton, TX 76203-5017
Marilyn.Wagner@unt.edu ◊ Phone: 940-565-3487 ◊ Fax: 940-565-3801
Please return this form via email to Dr. Marilyn Wagner (Marilyn.Wagner@unt.edu)
Please fill-in or check the grey boxes below:
Title of Program:
Type of Program (Please check one):
Conference
Seminar
Web-Based Course
Other___________
Sponsoring Department Information:
Sponsor’s Name (attach bio or vita):
Sponsor’s Department:
Sponsor’s College:
Program Information:
Program Faculty (attach a bio for each instructor):
Length of Program (days):
Location of Program:
Beginning Date (MM/DD/YYYY):
End Date (MM/DD/YYYY):
days
Institute
Workshop
Symposium
Total Instructional Hours:
hours
(attach program agenda or course syllabus)
Target Audience:
Anticipated Attendance:
attendees
Learning/Educational Objectives:
(attach extra page if necessary)
Assessments Planned:
(attach assessment description and evaluation that measures extent to which learning
objectives were achieved)
Contact Person Information:
Name:
Telephone:
Campus Address:
Email Address:
To be completed by UNT Lifelong Learning and Professional Development:
Approved: _____________________________
for _______CEUs Date__________
Marilyn D. Wagner, PhD, EdD
Director, Lifelong Learning
c: UNT Faculty Sponsor ________________________
Date Sent ______________
c: LLPD Program Manager______________________
Date Sent ______________
Download