North Mississippi Education Consortium (PC)

Did the course you are applying for Credits start in.....*
January-June 2021*
July-December 2021*
Upload the Certificate of Completion certificate.*
Accepted file types: pdf, jpg, png, jpeg.
Completion Date*
Date Format: MM slash DD slash YYYY
Instructor*
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*
District/ Organization*
Payment Information
Which credit are you applying for?*
- CEUs
- SEMIs
- OSLs
Payment Method*
- $16.50 - Credit/Debit Card
- $15.00 - Check/Money Order
NMEC Professional Development (PC)
Price: $16.50
Total Due
$0.00

Please complete the below evaluation about your online course experience.