lnstructions

  1. Applications for PCE Category II credits must be typewritten.

  2. Practitioners may apply for Category II credits for attendance at courses or programs which have not previously been submitted for course/program approval for PCEs by the sponsor.

  3. Only practitioners who are currently subject to mandatory continuing education may use this form to apply for Category II PCE credit. Please use one form for each activity submitted.

  4. Practitioners submitting this application for a continuing education activity other than those listed on the front of the application are requested to provide a brief description. Please specify independent studies" (i.e9 journal readings, college courses, teaching clinics, study groups, etc.).

    Refer to Practitioner Mandatory Continuing Education Book of Rules for policy regarding "unique circumstances" (page 4).

  5. Appropriate documentation of these activities must accompany this application. Such documentation must be identified with the individual practitioner name and certification number at the top of each page.

  6. The Practitioner Evaluation Form must also accompany this application.

Click on the link below to download the Application.  The application is an "RTF" Rich Text Format file generally able to be used by programs such as Word and Word Perfect.

If using Internet Explorer and Microsoft Word Processing Products the document may appear on your browser. 

If it does just select

  • File > Save As > Determine where to place the file on the computer

  • Name the file > Save

The document will be saved to the location identified and can then be used in the word processing software.

If using Netscape or other Word Processing Products the document may not appear on your browser. 

A security challenge may appear offering the option of opening or saving the document.  We recommend saving the document to a file.

  • Save it to Disk > Determine where to place the file on the computer

  • Name the file > Save

The document will be saved to the location identified and can then be used in the word processing software.
If you're asked for a password, type cancel