KPA CEU Request Form for Event Hosts Your InformationName* First Last Email* Event Promotional InformationThis information will be used to promote an approved event for KPA CTPs.Event Title* Speaker(s)/Instructor(s)*Click the plus sign to enter in more than one speaker/instructor. Speaker/Instructor NameQualifications/Credentials Event Description*When an event is approved for CEUs this description will appear in the event listing for KPA CTPs. Public EmailAn email for the event listing Promotional Website/Webpage What kind of event is this?* Seminar/Workshop Webinar/Lecture Conference Ongoing Course Is this an in-person or online event?* In-person Online Event Date & Venue Location*Use the plus sign to create additional entries if your event will occur more then once (not including a single event that is multiple-days).Start DateEnd DateVenue NameStreetCityState/ProvinceCountryZip/Postal Code Will attendees be attending a live or ongoing online event?* Live Ongoing Both- A recording or ongoing option for this event will be available for purchase after the live event. Date(s) of Event*If your event will be live on more than one occasion use the plus sign to add other dates. Start DateTimeEnd DateTimeTime Zone Dates event will be accessible*Please note that events are approved for KPA CEUs for up to 3 years. If your event will be available longer than 3 years you'll need to reapply for KPA CEUs after 3 years is up. You'll receive an expiration date for KPA CEUs with your approval notice.Start DateEnd Date Information for KPA CEU CalculationInstructional/Hands-On Hours*Please enter in the hours for each day of the event. For a multiple-day event use the plus sign to enter in the information for additional days. Lecture hours- Attendees will earn 1 CEU for each hour of lecture/instructional time. Hands-On Hours- Attendees will earn 1.5 CEUs for each hour of hands-on activities. Time spent "hands-on" includes activities where participants are individually working with a live animal under the direct supervision of the presenter or an event assistant. It also includes activities where the topic being discussed is put into practice by the participant while under the direct supervision of the presenter or an event assistant (ex. role plays or designing lesson plans for a workshop on improving client communications ).Topics coveredLecture HoursHands-On Hours * I understand that as event host, I will receive a KPA CEU code(s) for this event and am responsible for providing the codes to qualifying attendees.*PhoneThis field is for validation purposes and should be left unchanged.