Gravity Form to e-signature-CEU Administration Agreement Today's Date1212345678910111207123456789101112131415161718192021222324252627282930312023202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Full 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 #TermsCEU 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 basic for review, approval and payment