First name:
Last name:
Your contact information will be kept confidential.
Email:
Alternate email:
Phone:
Alternate phone:
Name of approved sponsor (see
list of approved sponsors
):
Title of program:
Date and time offered:
Is this a homestudy program (Homestudy is defined as any program where there is no ability for live interaction with the presenter)?
Yes, it is a homestudy program
No, it is not a homestudy program
Did you attend this program?
Yes
No
If you answered "no," please explain:
Have you attempted to resolve this issue with the organization listed above?
Yes
No
Standard(s) related to violation:
Standard A: Goals
Standard B: Program Management
Standard C: Educational Planning and Instructional Methods
Standard D: Curriculum Content
Standard E: Program Evaluation
Standard F: Standards for Awarding Credit
Standard G: Promotion and Advertising of Programs
Description of complaint:
Privacy Policy