Create CE Application Request

Select Application

Enter General Info

Verify Identity

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Enter General Info

Application Worksheets

These are the worksheets which will need to be completed during the application.

CE Checklist
Activity & Disclosure Information
Commercial Support
VMC Foundation Commercial Support Agreement
VMC Foundation Exhibitor Form
Professional Gap
Educational Needs
Desired Outcomes
Instructional Format
Desirable Physician Attributes/Core Competencies
Cultural & Linguistic Competence (CLC) AB1195
Clinical Content Validation (Standard 1)
Disclosure to the Audience
Evaluation and Outcomes
Program Review & Approval
Yearly Evaluation

Your Basic Information

First Name *

Last Name *

Phone Number *

E-mail Address * *

Main Conference Information

Conference Name *

Conference Location *

State

Proposed Date

*

Course Director Name *

Notes to CE Administrator

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