Instructions for Submitting an ASHA Cooperative Offering Application
Please submit a copy of your promotional materials with the CE application. This can be a flyer, brochure or other document. It must include a time-ordered agenda, financial and non-financial disclosure statements for each speaker, and a link to your event website where these statements must also be posted. NSLHA will provide you with a CE block to include in your promotional materials.
Below the CE block, please include this statement “This [conference/workshop/convention] is offered for up to _____ ASHA CEUs (____ level, _____ area). Once I review your time ordered agenda, I’ll let you know how many CEUs will be offered. The level options are Introductory, Intermediate, Advanced or Various. The area options are Professional, Basic Communication Processes, or Related.
Please indicate if you want your event to be listed on ASHA’s CEU Find (in other words are you opening it up to others outside of your organization to attend)?
If there are sponsorships being provided (financial or in-kind), those need to be disclosed in your promotional materials and also in the ASHA CE application. We’d need to list the name of each sponsor and what they are providing.
Will the type of learning experience be:
__ Group (live event)
___ Individual (e.g., recorded version of a live course or peer-reviewed, self-study) OR
___ Blended (i.e., courses that combine group and self-study experiences)
Is the course designed so that participants can achieve the all the course’s (or session’s) learning outcomes without full attendance (that is, is partial credit an option)? Yes or No
If yes (respond to the following):
How will course participants who do not attend the entire course demonstrate achievement of the course learning outcomes? (check one)
___ The course has multiple sessions and each session has discrete learning outcomes that are assessed at the end of each session.
___ The course is a series of sessions. Participants must attend a minimum of sessions.
___ A passing score on an exam is the satisfactory completion requirement.
___ Participant will successfully demonstrate a skill as the satisfactory completion requirement.
___ The course has group and individual learning components.
___ Participants can opt out of the individual learning portion of the course and earn credit of the group learning only.
___ Other (please describe):
How will you determine whether participants meet the course’s satisfactory completion requirements and are eligible to earn ASHA CEUs? (Check all that apply):
____ Attainment of learning outcomes
Disclosure question 1:
Does the course content focus on a specific product or service?
___ Yes, and a course content disclosure is available in the promotional materials.
If yes, provide the name of the product or service that will be discussed: _________________
____Yes, disclosure will be made at the start of the course for all instructional personnel. If this course is categorized as Individual (e.g., self-studies), disclosure will immediately precede the course content through audio or print delivery, dependent on format. (Must Agree)
If the course (event) will be offered more than once, please list the dates and city, state and times for each offering. Please include this information in your promotional materials, even if it’s offered one time only.
ASHA requires a financial disclosure statement and non-financial disclosure statement for each speaker and that information needs to be included in the promotional materials, as well as a time ordered agenda, course description, and learning objectives for each session that will be offered at the event.
Here are examples:
Financial Disclosure Statement: John Doe is employed by ABC Speech Therapy and is receiving honorarium for his conference session.
Non-Financial Disclosure Statement: John Doe has no non-financial relationships to disclose.
Please specify which subject code best fits each event that you’re offering.
ASHA requires submission of cooperative offering applications at least 45 days prior to each event. ASHA will send confirmation once the CE is approved, and it will be forwarded to you when received. However, you don’t have to wait for approval from ASHA to start promoting your event and accepting registrations.
ASHA’s cooperative offering fee is $325. NSLHA’s cooperative offering fee is $100. NSLHA can invoice you for the full amount, or you can provide credit card payment or a check. NSLHA submits each event application through ASHA’s online portal and pays the fee for each event with NSLHA’s credit card.
At each event, please provide each participant with this CEU participant form . If there are different numbers of CEUs that participants can earn (for example if there are concurrent sessions), then each participant will need to complete the “provider use only” section on their CE form. Please collect the forms at the event and mail them to Janet Seelhoff, NSLHA Executive Director, 1633 Normandy Ct., Suite A, Lincoln, NE. Janet will submit them with a CE Course Offering Report to ASHA. ASHA will send a final confirmation when the CE has been recorded for each participant.
You are welcome to create and issue CE certificates for each participant at the event, if you’d like.
Please contact Janet Seelhoff, NSLHA Executive Director, with any questions.