Form Rp-3042 - Application For Continuing Education Review
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2RP-3042 (01/99)
APPLICATION FOR CONTINUING EDUCATION REVIEW
Office of Real Property Services, Educational Services
16 Sheridan Ave., Albany, NY 12210-2714
518-474-1764; Fax 518-486-3799
This application is not intended to be used for training sessions or conferences sponsored by organizations
such as IAAO, NYSAA, NYSAC, NYSRPTDA or NYSAOT,
but rather for sessions sponsored by other
organizations.
First Name
Middle Initial
Last Name
Street Address
Fax Number
(
)
City, Town, or Post Office
State
Zip Code
Name of Course or Seminar
Exam
Required?
Yes
No
Sponsoring Organization
Instructor or Presenter’s Name(s)
Course Location (County, Town)
Course Begin and End Dates
___/___/___ to ___/___/___
Schedule/Hours per Day
Total Classroom Hours
Tuition Amount
______
$
Hrs.
_________
You MUST include a detailed course syllabus, or course outline along with this completed application.
Briefly explain what you hope to gain by attending this training session, and how it will relate to the duties
associated with your position.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
For ORPS Use Only (Do not write in this space)
Approved
Number of CE Credits: _________
Reimbursable Tuition Amount: $____________
Denied
_________________________________________________________
Comments:
___
_____________________________________________________
_____________________________________________________
_____________________________________________________
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