CHIME Events Continuing Education Credits

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CHIME committee and event participation should be submitted through the form below and can be added when the activity is complete ( i.e Fall Forum Planning).

Please fill in the event name, description of the event , event credits and the start and end dates (all fields for the first are required). If it is a one day event, the start and end date will be the same. CHIME recognizes one hour of participation as equivalent to one CEU. If you have questions regarding CEUs, email CHIME staff at certification@chimecentral.org. You may submit up to three events per form.

Name*
First Last
Organization Name
Event Activities
Add up to three activities below.
Event Title*
Event Description
Please include provider
Original live start date*
MM slash DD slash YYYY
Original live end date*
MM slash DD slash YYYY
Date viewed (if different from original live date)
MM slash DD slash YYYY
Number of credits*
Would you like to submit a second event for CEUs?
- Yes
- No
Event #2
Event Title*
Event Description
Please include provider
Original live start date*
MM slash DD slash YYYY
Original live end date*
MM slash DD slash YYYY
Date viewed (if different from original live date)
MM slash DD slash YYYY
Number of credits*
Would you like to submit a third event for CEUs?
- Yes
- No
Event #3
Event Title*
Event Description
Please include provider
Original live start date*
MM slash DD slash YYYY
Original live end date*
MM slash DD slash YYYY
Date viewed (if different from original live date)
MM slash DD slash YYYY
Number of credits*

CHIME Events Continuing Education Credits

Event Activities

Event #2

Event #3