NJ Chapter CPCU Instructor Interest Survey 2010

1. Default Section

The New Jersey Chapter CPCU Society is interested in expanding its cadre of insurance education instructors to fill the ever-increasing demand for quality education.

We appreciate your taking the time to answer the five questions below. Should you have any questions or require additional information, please contact NJCPCUExecDir@comcast.net.

Question Title

* 1. Are you interested in instructing the following types of workshops/courses for the NJ Chapter CPCU Society? Check all that apply.

One-hour CE workshop

Two-hour CE workshop

Three-hour CE workshop

Insurance designation courses such as CPCU, ARM, AIC, AFSB

Specify workshop topic or designation courses you would be interested in teaching.

Question Title

* 2. Please indicate the time of day you are available to teach. Check all that apply.

Morning

Afternoon

Evening (for example 5 PM - 7 PM, 6 PM - 8 PM time frames)

Optional Comments

Question Title

* 3. Please indicate the New Jersey geographic area(s) in which you are available to teach.

Question Title

* 4. Please provide your contact information so that we may follow up with you.

Name: *

Company/Agency:

Address:

Address 2:

City/Town: *

State: *

ZIP: *

Email Address: *

Phone Number: *

Question Title

* 5. Please provide a brief description of your qualifications for instructing the topics you indicated. 700 characters max. You may also forward your CV to NJCPCUExecDir@comcast.net.