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Requesting MVTA CE Approval for a CE Program
Please allow 4 weeks for your request to be processed
Name of person submitting program *
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Email address of person submitting *
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Program Date *
MM
/
DD
/
YYYY
Location *
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Organization Holding the Program *
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Lecture or program title *
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Number of credit hours requested *
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Detailed summary or outline of lecture *
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Name of presenter *
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Speaker bio *
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Learning objective #1 *
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Learning objective #2 *
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Learning objective #3 *
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Would you like the MVTA to advertise your event on our website? *
Required
Please provide registration information and time of lecture if you would like the event included on the MVTA CE Calendar.
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Any additional comments or questions?
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CE Certificate Sample must be emailed to ce@massvta.org if this is the organizations initial CE approval application
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