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OKLAHOMA CEU REQUEST FORM
CONTACT INFORMATION

Name: Organization:
Address:
City: State: Zip:
Tel: Fax:
E-mail:

MEETING INFORMATION

Meeting Title:
Cost(If Any):
Time & Date:
Meeting Site:

City: State: Zip:
County: Tel: Fax:


DESCRIPTION OF THE EDUCATION EVENT FOR WHICH CEU CREDITS IS BEING REQUESTED INCLUDING SPEAKER'S NAME AND BACKGROUND:

REQUESTED CONTINUING EDUCATION UNITS (CEU)

CEU REQUESTED**
Nutrient Management:
Soil & Water Management:
Integrated Pest Management:
Crop Management:
Professional Development:
Total:

CEU APPROVED
Nutrient Management:
Soil & Water Management:
Integrated Pest Management:
Crop Management:
Professional Development:
Total:
Approved Course Code:

**One hour of education = one CEU. Please do not include break periods.
Round hours for each category to the nearest 0.1 hour and total.



Your request will be emailed to you shortly. Please contact Dr. Hailin Zhang for more information
405-744-9566
hailin.zhang@okstate.edu
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Oklahoma State University - Stillwater | Stillwater, OK 74078 | 405.744.5000
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Oklahoma State University - Stillwater | Stillwater, OK 74078 | 405.744.5000
Copyright © 2006 Oklahoma State University | All rights reserved