CEU Class Submission Request Class Information Name* Full Email* Is this a new or existing client?*NewExistingIs this a new or existing class?*NewExistingIs this this class multiple days?*YesNoIs this class open to the public?*YesNoNumber of Students Allowed*Amount of CEUs to be applied for*Amount to be charged to client*Pay InformationPay is as follows: EMT Instructor - $250.00 Per Day EMT Aide - $200.00 Per Day 2 CEU Class - $75.00 Per Class 3 CEU Class - $100.00 Per Class Travel Time (If greater than 30 minutes) - $20.00 Per Hour (Paid in quarter hour incriments)Special InstructionsI.e. Wifi information, etc.CommentsThis field is for validation purposes and should be left unchanged.