CEU Request


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Official Chapter CEU Application Form for Chapter Workshops/Seminars

Do not use this form for Chapter Conferences with multiple concurrent sessions. Return to the CEU page and click on the Chapter CEU Application Form for Chapter Conferences.

APWA Chapters must submit a separate form for each Workshop/Seminar for which they wish approval to offer CEUs to participants. Application for CEU approval must be submitted to APWA at least 10 working days prior to the event date. APWA will notify the chapter contact of approval by email and include all of the procedures, participant forms, and validation stickers by email attachment.

A $35 application fee is due to APWA for approval of this application. Within five working days of receipt of this online application form, APWA will mail an invoice to the chapter contact for payment of this fee.

For an example of a completed form, click here.

Chapter Contact Information:

Sponsoring Chapter:

Name:

Title:

Organization:

Address:

City:

State/Province:

Zip/Postal Code:

Email:

Phone:

Fax:

Workshop/Seminar Information:

Title of Event:

Dates Scheduled:

Agenda:
Example

In the space below, list the complete agenda for this event, including beginning/ending times, instructional hours, scheduled coffee breaks and meals, etc.

Target Audience:

Learning Objectives:
Example

At the conclusion of this program, participants will be able to:

Instructor Information:

Instructor 1

Name:
Title:
Organization:
Address:
City:
State/Province:
Zip/Postal Code:
Email:
Phone:

Instructor 2

Name:
Title:
Organization:
Address:
City:
State/Province:
Zip/Postal Code:
Email:
Phone:

Instructor 3

Name:
Title:
Organization:
Address:
City:
State/Province:
Zip/Postal Code:
Email:
Phone:

Instructor 4

Name:
Title:
Organization:
Address:
City:
State/Province:
Zip/Postal Code:
Email:
Phone:

Evaluation:

I will fax a copy of my evaluation tool to APWA's Education Department at (816) 472-0406.
- OR -
I have attached a copy of my evaluation tool below.

Usage:
Example

How will the chapter use the information obtained through participant evaluations?

Description of EACH Educational Session (2-4 line sentence description) in your workshop/seminar

How would you like to submit the Description of Educational Sessions?
Attach with form:
Will Fax later to: (816) 472-0406, Attention: Education Department

Staff contact: Education Department