MSE CEU Application Form

Montana Society of Engineers (MSE)
Approval Process of Continuing Professional Competency Programs

The Continuing Professional Competency (CPC) committee will review:
- Continuing education courses, seminars, workshops, video taped courses/tutorials and professional or technical presentations made at meetings, conventions or conferences.

The CPC committee will not review or make recommendations for:

College courses, correspondence or authoring of published papers, articles or books.
REVIEW AND RECOMMENDATION/APPROVAL PROCEDURE

Submit a written request for evaluation and approval on the MSE application form. Include required attachments. Submit the application form a minimum of 45 days before the desired effective date of the approval.

The Administrative Secretary will forward copies to the members of the Continuing Professional Competency Committee for evaluation immediately after receiving them.

Each member of the CPC Committee will review the content of the submitted form and attachments by utilizing the evaluation criteria. Members of the CPC Committee will make a recommendation to the Chairperson regarding the approval (along with number of PDHs) or non-approval (along with reasons) of the educational activity. If a consensus is not met among the committee, the chairperson may call a meeting.

The Chairperson of the CPC Committee will complete the evaluation/approval form andforward it and the attachments to the President of the Board of Directors of MSE for recommendation or denial.

The President of the Board of Directors of MSE will make a recommendation regarding the approval or non-approval of the educational activity and forward the form and attachments to the Chairperson of the CPC Committee and the Administrative Secretary of MSE.The Administrative Secretary will notify the sponsor regarding approval or non-approval of the educational activity.

Montana Society of Professional Engineers

Application for Evaluation of Continuing Education Activity

Instructions:

Complete one form for each course.

Submit a fee of $50.00 for each course evaluation request. Make checks payable to Montana Society of Engineers.

Complete all sections below. Attach extra pages if necessary.

Name:
Email Address:
City
Street Address
State
Zip Code
Briefly describe the providing organization (if applicable):
Summarize the provider’s history of continuing education offerings (if applicable):
Is this a new course being submitted to MSE for the first time or a new version/repeat of a course previously approved by MSE?	New Course Previously Approved
Course(s) will be offered at:
City/State
Date
City/State
Date
City/State
Date
City/State
Date
City/State
Date
Course Title
Course Description
Has this course been previously reviewed and approved by the National Society of Professional Engineers or any state requiring continuing education. NSPE:	Yes No
Name of NSP Evaluator
Length of Course Instruction Time
Type of learning activity (check one):
If other, please describe.
Fee being charged per person:
Estimated enrollment at course location(s):
The target group(s) for this course are: (Mark all that apply.)	Land Surveyors Educators Attorneys Engineers Contractors General Public Survey Technicians Title Specialists Other
If other, please describe.
What are the instructional objectives of this program?
How does this program respond to the needs of the designated participant?
Why should a participant attend this program?
What is the potential for application of this course material?
How will a participant use this material professionally?
The instuctor will measure success of the program by having the participant:	Complete problems Take a test Fill out an evaluation form Other
If other, please describe.
Who designed this program? Please identify.	Individuals Organiztions
Has the program been offered before?	Yes No
Will certificates (proof of attendance) be provided to attendees?	Yes No
Please create a referral number to identify your application during any correspondence.

Free email forms

Print this next window and submit with $50 to the address listed.

MSE Application Approval used by MSE.