Form – CE – Proposal for Continuing Education Events

Name (Regiona Coordinator)*

Email (Regional Coordinator)*

Enter Email Confirm Email

Region*

Name of Establishment*

Address*

Proposed date and time of event*

Name of Speaker*

Title of Presentation

Number of expected attendees

Number of CE hours to be offered*

Budget

Expenses and projected income (enter if needed)

Projected Income

Registration fee to cover meeting expenses

Member fee?

Non-Member fee?

CE fee @ $10/hour (Not everyone will want CEs)

Projected Expenses

Speaker Fees

Meeting facilities

Refreshments (if planned)

Printing, duplicating

Other

Final Procedures for Regional Events

The CALPCC Treasurer will approve the event budget.
Income: Attendees will register with a credit card on the CALPCC website, so the Regional Coordinators do not handle registrations fees.
Expense Reimbursement: Two options:

Regional Coordinator submits an invoice to the CALPCC Treasurer (treasurer@calpcc.org), who will pay expenses directly to the vendor, speaker, facility, etc.
If the Regional Coordinator pays up-front expenses out-of-pocket, he or she can put them on a personal credit card and submit the receipts with the CALPCC reimbursement form to the CALPCC Treasurer, who will reimburse quickly.

Once the CE event has been approved, you will receive further instructions with required documents and information to allow CALPCC to award CEs.

Responsibility Statement

I have read and understand the procedures required to hold a CALPCC Regional Event. I agree to carefully monitor the process required for Continuing Education Events and agree to submit the required documents in a timely manner.

I agree (Type your name)*