Note: Appendices and form web pages open as new windows, which may be closed after reading and/or printing, so as not to overload your computer’s memory.
Please mail the completed CEU Request for Approval to Award CEU Credit Form along with the other required documents to Kyle Wallace (firstname.lastname@example.org) at the Office of the Vice Provost for Continuing Education, McKimmon Center for Extension & Continuing Education, Box 7401, NC State University, Raleigh, NC 27695-7401 with a copy of pertinent activity materials and program/instructional outline. You may submit the documents electronically to email@example.com.
The Request for Approval to Award CEU Credit Form is due at least 25 business days prior to the scheduled date of the activity. This information must be approved by an affiliated NC State content specialist. The information below is a guide for completing the application form, and all required forms can be found below:
Request for Approval to Award CEU Credit Application
- Course number is assigned by the office of the Vice Provost.
- The Activity Title must be as descriptive as possible.
- Number of days Activity.
- Number of instructional hours means number of contact hours. Do not count lunch or breaks.
- The number of CEUs to be offered will be assigned by the Office of the Vice Provost.
- NC State University faculty/extension content specialists are individuals having activity content expertise who have reviewed and documented the program content as being acceptable by the University.
- Program Sponsor means the name of the organization or NC State University unit that is offering the course or program.
- If the program sponsor is an NC State department/unit, the OUC number must be entered, along with bookkeeping and project information. This is necessary for University Planning and Research to satisfy University of North Carolina General Administration reporting requirements.
- Who should attend? – Identify the target audience by groups.
- The names of the instructors should appear on the form.* Attach resumes for all instructors or presenters.
- Program Director is the name of the program director/director who is responsible for the administration and logistical aspects of the program.
- Evaluation refers to the measurement of the quality of the activity as a whole, and assessment refers to the measurement of individual learning outcomes. Every activity must identify the means by which it will be evaluated. Assessment procedures are optional but preferred. Identify the test when the activity includes some kind of testing technique.
- CIP Content Code (pick list). Choose the category that best identifies the content area of the program.
- Industry Served Code (pick list). Choose the industry most served.
- Impact Code (pick list). Choose the category that best identifies the impact objectives of the activity.
- College/division-fill in the college/division of the program if applicable.
- Briefly record the learning outcomes (i.e., behavioral or performance objectives such as skills, knowledge and/or attitudes the learner should be able to demonstrate during or following the learning experience).
- Activity description should briefly describe each topic being offered. Please do not put “see attached” on the approval form, you must provide language describing activity. However, the program and/or instructional outline can be attached.*
- Activity Site. City, State, and Country.
- Dates of Activity. Give the beginning and ending dates of the program.
- If you are an NC State group, please provide billing information. (Project ID#)
* Information recorded on the Approval Form will be entered into an electronic database. Therefore, please do not use terms such as “see attached material” in lieu of completing the form.
All program information must be submitted for processing at one time with all of the required registrant information. Late registrations cannot be processed because CEUs cannot retroactively be awarded after the course has been filed with the Registrar. Individual participants cannot select whether or not they will receive CEUs; satisfactory completion of the stated criteria as developed and evaluated by the instructor/sponsor is the sole factor. All participants satisfactorily meeting the program criteria should be on the roster. An NC State ID number will be assigned to each participant.
Submit (electronically) a typed alphabetic roster using the preferred roster. List every participant’s name, address, email address, phone number, date of birth. This list must be signed by the qualified instructor certifying attendees met the minimum requirements for satisfactorily completing the program. All program information must be submitted for processing within 10 days after program completion with all of the required registrant information.