Transcription of Category II Application Continuing Education Credits
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Category II Application Continuing Education Credits
Category II ApplicationContinuing Education CreditsIMPORTANT:Refer to the instruction on the reverse for completing this II applications may be mailed to the address on the reverse or faxed to : _____Certification number: _____Five-year Continuing Education period From (year): _____ to(year): _____Indicate the Category II program/activity for which this Application is being submitted:nnBusiness/Commercial programnnStudy GroupnnMedical or Allied Health programnnCollege CoursennPublished ArticlennTeachingnnIndependent StudynnIn-house SeminarnnUnique CircumstancesnnLecture presentationnnHumanitarian WorknnOthernnTeaching ClinicDO NOT USE THIS FORM FOR EXHIBIT HALL ATTENDANCE Credits . PLEASE USE THE Category II EXHIBIT HALL whether you were a:nnParticipant ornnSpeakerCourse/program title: _____Sponsor: _____Date(s) and Location: _____PROGRAM EVALUATIONIn a paragraph, describe the knowledge you gained from your participation in this activity as it relates to orthotics,prosthetics, pedorthics, mastectomy or therapeutic shoes.
Category II Application Continuing Education Credits IMPORTANT: Refer to the instruction on the reverse for completing this application. Category II applications may be mailed to the address on the reverse or faxed to
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