Course Submission

Name and Professional Credentials

Name and Professional Credentials (Co-Presenter, If Applicable)

Email

Phone

What daywill you be offering the Course

Course Start Time

# of CEU's (Number Only)

Short Course Description (Approximatley 70 words)

Full Description

Course Objetives

Presenter Bio (if not already on website)

Co-Presenter (If Applicable)

Are there any documented the particiapnts of the workshop need prior to its start. If so pleae upload here.

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CHI Professional Development, Inc.

PO Box 85

Bellport, NY 11713