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Continuing Education / Presenter Application
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Email
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Full Name
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Email
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Phone Number
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Business/Organization Name
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NCBTMB Approved Provider Number (with a verification link)
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Your answer
CE Course Title(s)
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Your answer
Course Description(s)
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Length of Course (Hours/Days)
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Number of CEUs Offered
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Target Audience (e.g., beginner, advanced, specialties)
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Learning Objectives
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Teaching Format
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Virtual Lecture
In-Person Hands-on
In-Person Lecture
Hybrid Lecture / Hands-on
Other:
Materials or Equipment Needed
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Tech/AV Requirements
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TV monitor (used for projection)
USB cord
HDMI cable
Speakers
Other:
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Course Fee Structure (per session, per person, per series)
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Availability (preferred dates/seasons)
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Website and/or Resume link
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Professional Bio
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References from other venues (optional)
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