Course Endorsement Application

Information

Please complete all applicable questions and submit your application at least three months before the start of your course or event.

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Contact Name (Required.)

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Email (Required.)

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Name of Event or Course (Required.)

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Location of Course (Required.)

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Date of Event/Course (Required.)

Start

Date

End

Date

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How is your course funded? (Required.)

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If your event is industry sponsored, are the sponsors involved in the planning of the event? (Required.)

Yes

Other (please specify)

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Type of Course/Event? (Required.)

Standard/Basic HRA Course

HRA Hands-on Course

Advanced HRA Course

Seminar/Webinar

Other (please specify)

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* Contact Name (Required.)

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* Email (Required.)

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* Name of Event or Course (Required.)

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* Location of Course (Required.)

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* Date of Event/Course (Required.)

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* How is your course funded? (Required.)

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* If your event is industry sponsored, are the sponsors involved in the planning of the event? (Required.)

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* Type of Course/Event? (Required.)

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* Please attached a copy of proposed course or event agenda/syllabus and learning objectives: (Required.)

Contact Name (Required.)

Email (Required.)

Name of Event or Course (Required.)

Location of Course (Required.)

Date of Event/Course (Required.)

How is your course funded? (Required.)

If your event is industry sponsored, are the sponsors involved in the planning of the event? (Required.)

Type of Course/Event? (Required.)

Please attached a copy of proposed course or event agenda/syllabus and learning objectives: (Required.)