CHIME committee and event participation should be submitted through the form below and can be added when the activity is complete ( i.e Fall Forum Planning). Please fill in the event name, description of the event , event credits and the start and end dates (all fields for the first are required). If it is a one day event, the start and end date will be the same. CHIME recognizes one hour of participation as equivalent to one CEU. If you have questions regarding CEUs, email CHIME staff at [email protected]. You may submit up to three events per form. Name* First Last Organization NameEvent ActivitiesAdd up to three activities below.Event Title*Event DescriptionPlease include providerOriginal live start date* Date Format: MM slash DD slash YYYY Original live end date* Date Format: MM slash DD slash YYYY Date viewed (if different from original live date) Date Format: MM slash DD slash YYYY Number of credits*Would you like to submit a second event for CEUs?YesNoEvent #2Event Title*Event DescriptionPlease include providerOriginal live start date* Date Format: MM slash DD slash YYYY Original live end date* Date Format: MM slash DD slash YYYY Date viewed (if different from original live date) Date Format: MM slash DD slash YYYY Number of credits*Would you like to submit a third event for CEUs?YesNoEvent #3Event Title*Event DescriptionPlease include providerOriginal live start date* Date Format: MM slash DD slash YYYY Original live end date* Date Format: MM slash DD slash YYYY Date viewed (if different from original live date) Date Format: MM slash DD slash YYYY Number of credits*
