2021-2022 MDE CEU Applications

How was the Course Conducted?*
When did you complete the Course?*
Select the course you completed in Summer/July (Canvas-Self-Paced)
Select the course you completed Zoom/LIve*
Select the course you completed in Fall (Canvas/Self-paced)*
Select the course you completed in Fall Face to Face*
Select Which Fried Online/Microsoft Course you have completed
Which Phonics First Group were you Apart of?*
Date of Completion*
Date Format: MM slash DD slash YYYY
Upload the Certificate of Completion certificate.*
Accepted file types: pdf, jpg, png, jpeg.
Personal Information
Name*
First Last
Email*
Cell Phone*
Address*
Street Address City State ZIP Code
Birthday (Include Year)*
Educator ID / Last Four Digits of SSN*
School District*
School*
Payment Information
Which credit are you applying for?*
- CEUs
- SEMIs
- OSL
Payment Method*
- $16.50 - Credit/Debit Card
- $15.00 - Check/Money Order
2021-2022 MDE CEU Applications
Price: $16.50
Total Due
$0.00

Please complete the below evaluation about your online course experience.