American Public Works Association CEU Request Form ... FieldInspector … · The American Public...
Transcript of American Public Works Association CEU Request Form ... FieldInspector … · The American Public...
Please submit a copy of the completed CEU Request form and the survey evaluation to:
APWA, Attn: Heather DelaCruz, 2345 Grand Blvd, Suite 700, Kansas City, MO 64108‐2625 ‐ or ‐ Fax: (816) 595‐5315
The American Public Works Association ‐ CEU Request Form
MicroPAVER FieldInspector Overview (CLL14) Downloadable Program (.2 CEUs)
This is a two part form. For receipt of CEU Credits for downloadable programs, please submit a copy of the completed CEU Request form and the corresponding survey evaluation. CEU Request Forms that are submitted without an accompanying evaluation will not be processed.
By signing this form, I attest that I did participate in this education session, in its entirety.
Signature: ________________________________________________ Date:_____________
First Name: _________ Middle Initial: ___ Last Name:
APWA Membership Number: *Florida License Number (if applicable):
Job Title: Employer:
Address:
City: State/Province: Zip:
Email Address: (required)
Phone No. : Cell No.:
*IF you hold a PE License in Florida, and would like CEU credit - you MUST include your Middle Initial and Florida License Number on this form. APWA is an approved Florida Board of Professional Engineers training provider – 0003888.
The American Public Works Association has been accredited as an Authorized Provider by the International Association for Continuing Education and Training (IACET), 1760 Old Meadow Road, Suite 500, McLean, VA 22102; (703) 506‐3275.
*CEU requirements for water/waste water operators vary from state to state. Before you send in your CEU application, check with your state certifying agency to see if CEUs from APWA will be accepted.
Please direct CEU questions to Heather DelaCruz at (800) 848‐2792. You will be notified (via email) when your CEU Transcript has been processed and is available for secure download via APWA’s web site at http://www.apwa.net/Education/CEU.
APWA Finance Use Only: iMIS#_______________ Transaction #___________ Last 4 Digits of CC__ __ __ __ Date_________
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If you have a current APWA Membership, there is no charge for CEU registration; however,
if you are NOT currently an APWA Member, the cost of CEU registration is $7 USD.
Non‐Members Only ‐ please complete the following payment information and submit your payment of $7 (USD) via check, Visa, Mastercard or American Express.
□ Check Box for Receipt (alternate email address for receipt: _____________________________________________)
Name on Card: Authorized Cardholder Signature:
__ __ __ __-__ __ __ __-__ __ __ __ -__ __ __ __ Exp Date: __ __/20__ __ (VISA, MasterCard or American Express) (mo.) (yr.)
Please submit a copy of the completed CEU Request form and the survey evaluation to:
APWA, Attn: Heather DelaCruz, 2345 Grand Blvd, Suite 700, Kansas City, MO 64108‐2625 ‐ or ‐ Fax: (816) 595‐5315
The American Public Works Association ‐ CEU Request & Evaluation Forms
MicroPAVER FieldInspector Overview (CLL14)
This is a two part form. For receipt of CEU Credits for downloadable programs, please submit a copy of the completed CEU Request form and the corresponding survey evaluation. CEU Request Forms that are submitted without an accompanying evaluation will not be processed.
Please rate the items below by placing an “X” in the appropriate boxes below.
Session Content: Poor Fair Good Very Good Excellent
Program Content
Relevance of Topic
Overall Session Rating
After attending this session, I am now better able to: Strongly Disagree
Disagree Neutral Agree Strongly Agree
Explain how FieldInspector could be integrated into my agency’s pavement management plan.
Determine what data is the most valuable. Utilize the tools in the software.
Skill of speaker(s) in presenting message:
Would you recommend to speak again? Poor Fair Good Great
Would you recommend to speak again?
Yes No
Scott McDonald
Moderator: Teresa Hon
Comments:
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www.apwa.net
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2013 APWA Congress Activities Related To MicroPAVER
When:
Entire Conference
On the exhibit floor
Visit booth #750
For Product Information
When:
Tuesday, Aug 27, 11:00‐11:30am
In The Convention Center Lobby
Stop by the DCS Center
For purchasing
and subscription information
When:
Tuesday, Aug 27, 2:30‐4:00pm,
In Room E26
For MicroPAVER
Open forum
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Our Moderator
Teresa HonProfessional Development Program Manager
Polling Questions
If you are in full screen mode, you will need to minimize the screen to vote
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Our Speaker:
Scott J. McDonaldDirect: +1 (720) 475 7036Cell: +1 (970) 567 2792
Email: [email protected]
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FieldInspector Activation
Validation Registration
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Activation Code
Activated
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Software Simulation
QUESTIONS ???
To Ask A Question
Type It In The Question Pod At The Bottom Of Your Screen And Hit Submit
If You Are In Full Screen Mode You Must Minimize Your Screen To Access The
Question Pod.
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Please remember to fill out the online survey at:https://www.surveymonkey.com/s/PaverfieldinspectorThis program is worth .2 Continuing Education Credits.To request your CEU’s you must complete the survey.
Thank you!
The American Public Works Association has been accredited as an Authorized Provider by the International Association for
Continuing Education and Training (IACET),
1760 Old Meadow Road, Suite 500, McLean, VA 22102; (703) 506‐3275.
2013 APWA Congress Activities Related To MicroPAVER
When:
Entire Conference
On the exhibit floor
Visit booth #750
For Product Information
When:
Tuesday, Aug 27, 11:00‐11:30am
In The Convention Center Lobby
Stop by the DCS Center
For purchasing
and subscription information
When:
Tuesday, Aug 27, 2:30‐4:00pm,
In Room E26
For MicroPAVER
Open forum
8/14/2013
9
www.apwa.net