CEU Administration Agreement Form

Gravity Form to e-signature-CEU Administration Agreement

Today's Date

Full Name(Required)

enter First and Last Name

Organization or Company

email(Required)

Street Address(Required)

City(Required)

State(Required)

USE 2-DIGIT ABBREVIATION (ex. Virginia = VA)

ZIP(Required)

AOTA #

ASHA #

CEU Administration Consultant agrees to

File continuing education courses on behalf on TalkTools with the CEU approval/regulatory organization

$50/hour rate paid to CEU Administration Consultant for services outlined in the Agreement

File TalkTools continuing education courses in a timely manner according to the filing deadlines required by the CEU approval/regulatory organization

Provide hours to TalkTools on a monthly basis for review, approval and payment