CEC Submission Form (Category 2)

CEC Submission Form

(Category 2)

Use this form to enter continuing education (CE) credits earned by participating in Category 2 CE activities (not pre-approved or not offered through the Wellness Alliance). Documentation of hours and attendance is required for each event. Upon approval, CE credits will be applied toward CWP re-certification in your Professional Development Journal.

PERSONAL INFORMATION

Today's Date*

Member/Nonmember ID*

You can find your Member or Nonmember ID under the Profile section within "Account + Settings" when you log in to your Wellness Alliance online account.

First Name*

Last Name*

CWP Expiration Date*

You can find your CWP Expiration date under the "Personal Information" section within "My Profile" when you log in to your Wellness Alliance online account.

ACTIVITY DETAILS

Please provide the following details about your continuing education activity.

Please enter the activity start and end dates accurately. If the number of CE credits you are claiming are unreasonable for the time frame you have submitted (e.g., submitting 35 CE credits for a one-day event), your submission will be denied.

Start Date*

For one-day activities, enter the date of the activity. For multi-day activities, enter the date of the first day you attended.

End Date

Activity Title*

Activity Organizer*

Please list the organization through which the continuing education was offered.

Presenter and Credentials*

Enter the name or names of the presenter(s) and their credentials.

Activity URL

Optional. You may supply a URL to more information about the activity. URLs must begin with "http://" or "https://"

Type of Activity*

The educational content must be intended for an audience of wellness professionals. CE credits may not be claimed for activities that are part of daily job requirements.

Select

CONTINUING EDUCATION CREDITS

# of CECs*

1 hour of instruction = 1 CE credit. Time spent in non-education periods (breaks, meals, poster sessions, networking sessions, meetings, etc.) or time that you spent presenting does not count. Round down to .25 hour (15-minute) increments for partial hours. For academic courses, you may claim 3 Category 1 CE credits per semester credit hour or 2 Category 1 CE credits per trimester or quarter credit hour.

Was this activity approved by another organization for continuing education credit?*

Select

If yes, which organization(s)?

In a short paragraph, please describe how the activity relates to your certification(s) and what you gained from this experience:*

CE CREDIT DOCUMENTATION

File Upload

Additional documentation to support your submission may be uploaded here. It is the responsibility of the certification holder to retain documentation of CE credits earned.

Additional documentation may be requested. Certification holders should retain the following documentation:

Title, date, presenter and length of activity.
If the activity consists of multiple sessions (as in a conference), the title, date, presenter and length of each session attended.
Proof of participation in the form of a certificate of participation (preferred) or a registration confirmation/receipt.
In the case of academic coursework, the ability to provide a transcript confirming credit hours.

Drag and drop files here or

Initials*

By entering your initials, you agree that you have represented your CE credits accurately and are able provide the necessary documentation upon request.

Send me a copy of my responses

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