Application for Endorsement of Continuing Education Course Application fee $75.00 First Name Last Name Your Email Name of Course Date of Application Date of Course Name of Contact Address of Course Contact Phone Number Contact Email Address Purpose of Course Course learning objectives (must list at least 3) Name of credentials of all instructors Describe the experience the instructors have in teaching this course How many hours of continuing education are you applying for? Who is the target audience? Expected Enrollment Course sponsor (if applicable) Do you want to advertise this course through UOTA (if this is checked "Yes" a UOTA board member will contact you) Yes (Click "Send" to submit application, then pay the fee by clicking the button below.) Pay Application Fee