Certificate Request Form

Complete the following information to request a Certificate of Attendance. Once submitted, CEU Institute will review the course attendance records for eligibility to receive a certificate of attendance.  If eligibility is confirmed, a copy of your certificate will be emailed to the email address provided.

Requests for certificates 90 days past the course date will be subject to a $7.00 processing fee.  (This fee is to offset the cost of opening and investigating the course attendance record archives)

Fields marked with a * are required.

COURSE INFORMATION


INDIVIDUAL SEEKING CERTIFICATE


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Thank you so very much for assisting us in presenting this very necessary training to our care management staff.
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