Dyslexia Training Credit application

I understand that I have six months after completing a workshop to apply and pay for the credits?*
- Yes
I understand that if payment isn't received within 3 weeks of applying for CEUs that my application will be voided.?*
- Yes
All credit application received after six months of completing the date will automatically be voided, and if payment is received a $15.00 refund will be submitted

Select the course you completed*
Questions on how to complete the credit application correctly, watch video: https://www.youtube.com/watch?v=Db0qI6s4zKg
Date of Completion*
MM slash DD slash YYYY
Upload sign in sheet or Certificate of completion*
Drop files here or

Max. file size: 500 MB.
All certificates or sign in sheet uploaded without participants name on it, will be automatically voided!!!
Upload Fifth Hour Case Study Assignment*
Accepted file types: pdf, jpg, png, jpeg, Max. file size: 500 MB.
If you have questions about what to upload please refer the the video found here: https://www.youtube.com/watch?v=Db0qI6s4zKg Case Study completed: https://www.mdek12.org/sites/default/files/Offices/MDE/OAE/OEER/Dyslexia/mde_dsylexia_training_case_study.pdf
I understand that if my credit application is not completed correct the application will be voided.*
- Yes
If applicable the certificate of completion must match the course selected and participants name. If payment received, a $15.00 refund will be sent. (Once uploaded, you will see the document title in red)
Personal Information
Name*
First Last
Email*
Cell Phone*
Address*
Street Address City State ZIP Code
School District*
School*
Which credit are you applying for?*
- CEUs
Educator ID*
Payment Information
Payment Method*
- $16.50 - Credit/Debit Card
- $15.00 - Check/Money Order
Dyslexia Training
Price:
Total Due
$0.00

Please complete the below evaluation about your course experience.