Section 5: Course and Offering Registration Form
This section explains how to register courses and offerings using the appropriate ASHA form. Specific areas have been highlighted where we think you may have questions.
The Course and Offering Registration Form is divided into eight sections.
- Course Information and Description
- Course CEUs
- Disclosure and Promotional Materials
- Course Design
- Planning and Instructional Personnel
- Satisfactory Completion and Course Evaluation
- Course Offerings
- Attestations and Signature
I. Course Information and Description
Provider Code & Name of ASHA Approved CE Provider
It is important that you include both the 4-letter Provider Code assigned by ASHA CE and the name of your organization that was approved by ASHA CE on the course registration form to ensure that the course is registered under the correct code and provider.
Provider Code: AAAE
Name of ASHA Approved CE Provider: Massachusetts Speech Language Hearing Association
Provide a unique 4-digit number to identify your course. Each course number may only be used once.
The title of your course should be limited to 60 characters, including spaces and punctuation. Acronyms should be spelled out the first time they are used, including in the title of your course. Choose a professional-sounding title that shows the relevance of the course to the SLP or audiologist.
A complete but concise description should include key learning outcomes or key elements of the course. Here are some tips for writing:
- View your description through the eyes of state licensure board personnel for readability and content; assume that they are not familiar with your organization or with any products/techniques mentioned.
- Make sure the description shows the connection to the science and practice of speech-language pathology and/or audiology.
- Write in the past tense because the description will appear on transcripts after the fact.
- Spell out acronyms the first time they are used.
- Use person-first language (person first; disability second).
- Keep within the maximum 300-character limit.
The subject code appendix [PDF] shows how the content of your course pertains to the science and practice of speech-language pathology and/or audiology. The subject code appendix describes each subject code. If more than one subject code seems appropriate, choose the one that covers 50% or more of the course.
List the first letter of the code. There are three content codes:
- B—Basic Communication Processes: Information dealing with the basic science and normal development of speech, language, and hearing.
- P—Professional: Information and techniques dealing with the diagnosis and treatment of speech, language, and hearing disorders; will be used by SLPs and audiologists directly in their work with clients.
- R—Related: Topics such as services provided by related professions, learning theory, Medicare requirements, regulatory issues, business practices.
Subject codes and content codes are matched as shown in the subject code appendix. For instance, subject code 2010 can only be designated as B, subject code 3010 can only be P, and subject code 7050 can only be R.
Tip: When filling out the Course and Offering Registration Form, use the designations B, P or R. In the ASHA promotional paragraph, however, spell out each word; participants will not be familiar with the abbreviations.
List the number that corresponds to the appropriate level of course instruction for the amount of familiarity your participants should have within the area covered. (1=Introductory, 2=Intermediate, 3=Advanced, and 0=Various) The designation of "0 = Various" should be used only if your course has multiple, unrelated sessions or tracks (i.e. conventions or multi-day seminars).
Will this course be offered more than once?
Check this box to indicate if you plan to offer your course more than once during the calendar year. You will list offering dates and locations under Section VII of this form.
Instructors, dates and locations can vary. But all other elements of your course should be the same, (i.e. course title, course description, learning outcomes, agenda, CEU amount and learning assessment). For more information about multiple offerings see Section 6 of Tutorial.
ASHA has recently changed from requesting Course Type to requesting the Type of Learning Experience. Here are the three options for Learning Experience:
- Group: Participants learn with a cohort of other learners, in the same learning event and often in the same location at the same time. (For example, workshops, seminars, conferences, conventions, study groups, grand rounds, etc.)
- Individual (i.e. self-study): Participants interact independently with the learning materials according to their schedules. (For example, archived online course, journal/newsletter, videotaped course.)
- Blended: Participants learn through both group and individual learning experiences. May require a pilot study to determine CEU amount.
Do you want your course listed on Course Search?
Check this box if you want your course listed on Course Search. If your course is only available to a limited audience or is closed to the public then do not check this box. Course Search is a tool on the ASHA website that allows ASHA members to look for courses registered for ASHA CEUs that are open to the public.
Registration Contact Information—If you want your course content listed on Course Search, you can provide course registration contact information here. You can list contact name, phone number, e-mail, and/or web link.
II. Course CEUs
II. Course CEUs
CEU amounts: 00.1 0 (e.g. 60 minutes = 0.1 CEU)
Fill in the maximum number of CEUs that will be offered for this course.
This must match the CEUs listed in the CEU sentence found in the course's promotional materials. See CEB Manual, Requirement 3 and Section 3 for instructions on calculating CEUs.
To calculate: add up minutes spent in course sessions, round down to the nearest ½ hour and divide by 10. See this chart on how to translate this number to the correct CEU amount. ASHA CEUs are based on learning time – do not include registration time, lunch, breaks, business meetings, product sales and marketing promotions into your calculations.
What is partial credit? Conventions, large conferences with multiple tracks, and journal study groups may have participants who cannot attend all of the training hours available, but still meet the learning outcomes of the course.
If the course is appropriate for partial credit, check the mechanism by which course participants will demonstrate achievement of the course's (or session's when a convention) learning outcomes.
III. Disclosure and Promotional Materials
In this section, you are required to answer four questions concerning how course and speaker disclosure information will be announced to participants.
You are also asked to attach a copy of your primary promotional materials for this course. Your primary promotional piece (brochure, e-mail, flyer or web page you are using to announce your course) must include the required ASHA CE Provider Brand Block/Logo and CEU sentence and speaker disclosure statement. This is a requirement regardless of whether or not the course is open to the public. Reference: CEB Manual.
Sample Brand Block
CEU sentence: This program is offered for 1.0 ASHA CEUs (Introductory level; Professional area.)
Sample disclosure statement: Disclosure: "Speaker" has no financial or nonfinancial relationships related to the content of course to disclose. The CE Provider Brand Block is personalized for each provider. Your Provider Manager can e-mail you a copy of your personalized Brand Block or a CD can be mailed to you with your Brand Block in different file formats. You may not edit or alter this image. Instructions for how to properly present your Brand Block and Speaker Disclosure Statements are available on ASHA's website.
IV. Course Design
Check all mechanisms used to determine the educational need for this course content. See CEB Manual, Requirement 4 and Appendix G.
Attach the course's learning outcomes (i.e. skills, knowledge and/or attitudes that a participant will demonstrate as a result of this course). See tips for writing learning outcomes.
Assessment of Learning Outcomes
Check all the tools used to assess the degree to which course participants have achieved the course's (or session's) learning outcomes. See CEB Manual, Requirement 9 and Appendix I.
Check all the methodologies that will be used to support achievement of the course's learning outcomes. See CEB Manual, Requirement 8.
V. Planning and Instructional Personnel
Check the box acknowledging that your organization has a process for identifying and selecting instructional personnel that is compliant with the CEB's Requirement 6. See CEB Manual, Requirement 6. Please do not attach resumes or vitae.
This question is for data collection only. Check yes, if you're utilizing the evidence-based CE resources available at Resources for Presenters.
Disclosure of Conflicts of Interest
Check all the ways in which you will disclose instructor conflicts of interest and affiliations to course participants before the course begins. See CEB Manual, Requirement 6.
VI. Satisfactory Completion and Course Evaluation
Check all the ways used to determine a participant's satisfactory completion of the course. See CEB Manual, Requirement 9.
Check the box to acknowledge that your organization has a process for collecting course evaluation data, analyzing evaluation data, and responding to the results of the analysis that are compliant with the CEB's Requirement 11.
You do not need to attach the evaluation form.
VII. Course Offerings
For group or blended courses, provide all of the scheduled course offerings' starting dates and ending dates in MM/DD/YY format.
For individual (i.e., self-study), provide a schedule for reporting course participants. For example, if you'll report monthly, the start date of the first offering might be 01/01/XX and the end date 01/31/XX and so on.
Attach the Additional Offering form(s) if you have more than twelve offerings scheduled when submitting the Course and Offering Registration form.
While providers will assign course numbers, ASHA CE will assign offering numbers. You will be e-mailed a course registration confirmation letter that will list each offering number.
City, State, Country
Provide the physical location where the course will be offered. Leave blank if distance learning (if the course is being offered at a distance as in online or via teleconference).
Check yes for each course offering to be conducted with another organization. For further information on what is a cooperative offering see Section 5 of the tutorial. See CEB Manual, Section 3.
Is this a cooperative offering?
Provide the name of the cooperative organization, the contact person, phone number and e-mail address.
Cooperative Payment Information
The appropriate cooperative offering fee must be submitted with the Course and Offering Registration form unless the cooperative organization is also an ASHA Approved CE Provider. See the fee schedule in the CEB manual or on ASHA's website. Attach a check (payable to ASHA) in the appropriate amount or complete all credit card information requested.
VIII. Attestations and Signature
Read and check each item to indicate your agreement. We will accept an electronic signature.
[Provider Only Home Page | Previous Tutorial Section | Quizzes | Next Tutorial Section | email@example.com]