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Membership

Chapter Technical Session Request Form

INSTRUCTIONS:  Use this form to request the Foundation to review all chapter CPE programs.  Only programs pre-approved by the Foundation will qualify for CPE credits and notification will be sent to the sponsoring committee chairman within one week of receipt.  Forms are due in the Foundation office 4 weeks prior to program date. Please note that program presentation materials are due 2 weeks prior to the program.

NOTE: COURSE MAY NOT BE PROMOTED TO THE MEMBERSHIP UNTIL THIS FORM IS RETURNED AND TOPICS ARE APPROVED FOR CPE CREDIT.

Please complete the information listed below. You can also download and print the request formand return it to Lelia Dickenson, Manager of Chapter Relations, email ldickenson@nysscpa.org

Section 1 - Sponsor Information
Section 2 - Program Information
Registration Fees
Online Registration
 
Program Registration Contact
(If different from main contact above)
Section 3 - Program Content
(For descriptions of the following program components, refer to the CPE Course Standards and Procedures Section of the Chapter Handbook)
Please include up to 3 topics to be covered in this session
CPE Credit Requested:
Please indicate the number of credits in each field of study (Note: 50 minutes equal 1 CPE credit, no half-credits allowed)
Number of Credits


 
Field of Study (check all that apply)




 
Include breakdown if more than 1 field of study
Course Level (check one)



 
Method of Presentation (check all that apply)



 
Section 4 - Instructor Information
(Attach a biography or resume for each instructor, for more than 4 instructors, upload word document with full instructor list)
Speaker 1
Include Name, Firm, Address, Email and Phone
Speaker 2
Include Name, Firm, Address, Email and Phone
Speaker 3
Include Name, Firm, Address, Email and Phone
Speaker 4
Include Name, Firm, Address, Email and Phone
Attach any files here