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CEC Submission Form

First Name: *
Last Name: *
Address: *
City: *
Province/State: *
Country: *
Postal/Zip Code: *
Phone: *
Fax:
Email: *
Program Title: *
Program Sponsor: *
Application Type: *
Date(s) of Program: * to 
Program agenda/brochure including topics covered, time schedule and speaker information: *
Proof of Attendance (which may include an official receipt, ABGC issued CEU certificate or letter of attendance): *
Fee:$0
CEC Submission Fees:Individual Course Attendees
    Standard Fee - $25.00
Conference Organizers
    Standard Fee - $100.00 - for conferences occurring 3 months away or greater
    Rush Fee - $150.00 - for conferences occurring fewer than 12 weeks but more than 4 weeks in advance of event
    Urgent fee - $200.00 - for conference occurring in less than 4 weeks