Individual Participant Request (IPR) Submission

Form used to claim CE credit for extramural courses.

From your profile
From your profile
From your profile
From your profile
MM slash DD slash YYYY
MM slash DD slash YYYY
Excluding breaks
Max. file size: 256 MB.
If available
Max. file size: 256 MB.
Toward which specialization / credential will you apply this credit?
CHIS competencies
DSS Level I skill areas
DSS Level II skill areas
SRSS Level I skill areas
SRSS Level II skill areas
MLA Competencies for Lifelong Learning and Professional Success
For credit toward an AHIP application, please identify which MLA Professional Competencies this activity addressed
For credit toward an AHIP application, please describe the relevance of this activity to your goals for professional growth and development.