Course Submission Form

Course Submission Form

Incomplete forms will not be reviewed. For additional instructions review the IDCEC Presenter’s Guide. Please be sure to submit 5 copies of this submission form and 5 copies of your course materials/handouts.

Payment Information:

Please select one organization to manage your IDCEC submission. This organization will ensure your submission materials are complete and coordinate your IDCEC review with ASID, IIDA and IDC.

  

Mail to: Mail to:Mail to:

ASID Education Dept.IDC Education Dept.IIDA Education Dept.

608 Massachusetts Ave. NEC536 -43 Hanna Avenue222 Merchandise Mart, Suite 567

Washington, DC 20002Toronto, Ontario M6K 1X1 Chicago, IL 60654

The fee for an IDCEC course submission is US$100 ($150 Canadian), payable to the organization who is managing your submission. IDCEC submission fees are not refundable. It can take up to 10 weeks for your IDCEC submission to be processed. You may not promote your event as IDCEC approved prior to official notification.

Cheque: #______Credit Card:  American Express  Visa  MasterCard

Name on Card:
Card Number:
Expiration Date: / Security Code: / Amount Paid:

Terms:By signing this form, I understand that my payment is non-refundable, regardless of the outcome of this request forCEU approval. The final decision on approval rests with IDCEC. If approved, I understand and agree to abide by the terms, standards and conditions of IDCEC in executing this course.

I agree to indemnify, defend and hold harmless IDCEC (including its affiliates, officers, members, agents, successors and employees) from and against any and all claims, demands, causes of action, losses, damages, fines, penalties, liabilities, costs, and expenses, including attorney's fees and court costs, sustained or incurred by or asserted against IDCEC arising out of or relating in any manner to the development/delivery of this course or any act of negligence or misconduct by its authors/instructors. This indemnification shall survive the term of this course approval.

I verify that I have read the Official IDCEC Presenter’s Guide and agree to the policies, processes, criteria, and guidelines set forth in the guide.

Signature: / Date:
Course Title:
Subject Code: / Length: (in minutes)
Instructor(s):

Date:(If ongoing, date of first presentation)

Use of Course: (Check one)Type of Presentation: (Please check the type.)

One-time only In-person presentation:

Ongoing Lecture Field Lab

Distance learning course:(Please be sure to fill out the Distance Learning Supplement)

 Web based Telephone based  Publication  CD/DVD

Submitted by:

Name:
Firm Name:
Address:
Telephone: / Fax: / Email:

Learning Objectives:(Add additional rows as need.)

1.

2.

3.

4.

Content Outline: (Must be broken down into 15 minute increments or less)

In the space provided, please illustrate the course schedule/syllabus by listing the topics addressed, any pertinent sub-topics. Add additional rows as needed.

Order / Description of Topic/Content / Duration
1
2
3
4
5
6
Total

Course Description:(Maximum of 100 words.)

Intended Audience:

 Residential Office/Corporate Government/Institutional Retail/Store Planning

 Health Care Hospitality/Entertainment Facilities Management Other ______

Maximum Audience Size:

Degree of Interactivity:Low Medium High

Classification of Learning Levels

Basic IntermediateAdvanced

Bibliography:(Note: Bibliographies with only websites are not sufficient.)

Sample: Henley, Patricia. The Hummingbird House. Denver: MacMurray, 1999.

1.

2.

3.

Requested Designation: Health/Safety Welfare General

1

Interior Design Continuing Education Council  2009

3/11

Course Submission Form

Facilities and/or Equipment Required:

Interested party may not be able to provide all AV equipment. Specialty equipment should benegotiated with the interested party.

 Classroom seating with tables /  Overhead projector/screen /  Microphone
 Auditorium seating /  Slide projector/screen /  Lectern
 Other seating /  VCR/screen /  Personal computer
 LCD projector/screen /  Internet access

 Other (please specify)______

Prior Course Presentation:

Identify if your course has been presented before, to which organization or group, and the date(s) of presentation. Attach additional pages, if necessary.

Please be sure to submit 5 copies of all forms and course materials.

1

Interior Design Continuing Education Council  2009

3/11