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Form Re-620-124 - Instructions For Completing The Secondary Provider Course Content Approval Application

Instructions for Completing the Secondary Provider

Course Content Approval Application

or revised. This can result in the issuance of a

Provider Information

1. Provider name and ID number: Use the approved

new course ID number. Also be aware of the

name your school was approved under and use

expiration date affecting the course. The original

the appropriate approval number issued to you.

provider has submitted this course for renewal

and therefore has a new expiration date. This

2. Address, telephone number, fax number, and e-

expiration date will be your expiration date, also.

mail address: Include PO box and suite number,

if applicable.

3. Original provider/course developer and school ID:

This is the name and ID number for the original

3. Contact person and telephone number: List the

provider/course developer from whom you

name of the contact person for this school. Include

received authorization to use this course.

the telephone number where the contact person

can be reached, if different than the school

What to Include With This Application

telephone number.

1. Please include a written authorization by the

original education provider/course developer

Course Information

permitting use of the course content.

1. Course title: Use the exact course title used by

the original provider/course developer.

2. If this course will be delivered using a distance

education delivery method, please attach a

2. Original provider/course developer course ID

completed Distance Education Delivery Method

number, number of clock hours, and expiration

Approval Application (form RE-620-126), unless

date used by the original provider/course

this course has been certified by ARELLO for your

developer. Be sure to contact the original

school.

provider/course developer of the course for any

updated information concerning the course.

3. Attach the ARELLO certificate if this course has

Occasionally courses must be moderately updated

been certified through them for your school.

Incomplete or unsigned applications will not be processed

A completed application is processed within 45 days of our receipt

RE-620-124 SEC. PROV. COURSE CONT. APP . (R/6/00)FM/W Page 1 of 2

Form Re-620-124 - Instructions For Completing The Secondary Provider Course Content Approval Application

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