Non-CHIME Continuing Education Units

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Please fill in the event name and provider, description of the event , event credits and the start and end dates (all fields for the first are required). If it is a one day event, the start and end date will be the same. CHIME recognizes one hour of participation as equivalent to one CEU. If you have questions regarding CEUs, email CHIME staff at certification@chimecentral.org. You may submit up to three events per form.

Name*
First Last
Organization Name
Event Activities
Add up to three activities below.
Event Title*
Event Description
Please include provider
Number of credits*
Event start date*
MM slash DD slash YYYY
Event end date*
MM slash DD slash YYYY
For credits over 10.0, please provide an agenda to verify CEUs earned
Max. file size: 32 MB.
Would you like to submit a second event for CEUs?
- Yes
- No
Event #2
Event Title*
Event Description
Please include provider
Number of credits*
Event start date*
MM slash DD slash YYYY
Event end date*
MM slash DD slash YYYY
For credits over 10.0, please provide an agenda to verify CEUs earned
Max. file size: 32 MB.
Would you like to submit a third event for CEUs?
- Yes
- No
Event #3
Event Title*
Event Description
Please include provider
Number of credits*
Event start date*
MM slash DD slash YYYY
Event end date*
MM slash DD slash YYYY
For credits over 10.0, please provide an agenda to verify CEUs earned
Max. file size: 32 MB.

Non-CHIME Continuing Education Units

Event Activities

Event #2

Event #3