Request Credit

Date of Request 02/23/2012
Provider Name (Chapter, Council, Forum, etc.)
Event Host
Event Location
Host’s Phone
Host’s Fax
Host’s E-mail
Host’s Website
Instructor Name
Instructor Qualifications
Does your speaker have a compensation agreement with PDCA National?
Course Title
Course Date
Course Start Time
Course End Time
Course Description
Learning Objective 1
Learning Objective 2
Learning Objective 3
Learning Objective 4
Delivery Method
Course Category (select all that apply) Accounting
Business Development
Finance
Human Resources
Management
Production
Products/Equipment
Risk Management
Sales/Marketing
Technical