Professional Development Series Application

Fill out the SCAEOP Professional Development Series Application

Thank you for your request for a SCAEOP Board Member to visit your association.
Please note this form must be received 60 days before the expected visit.

Please fill out form below and contact SCAEOP President Elect Kimmetta Tidwell, CEOE, ktidwell@fairfield1.org
if you have any questions.

* Indicates required field

Name of Officer Requested *

First

Last

Date of Event *

Time of Event *

Length of Presentation *

Additional Information *

Location *

City *

Requesting Association *

Email(s) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Contact Person for Requesting Association *

First

Last

Phone Number *

Fax Number *

Participation requested: (please check all that are applicable) *

If you answered other, please specify. *

A contribution to the SCAEOP Professional Development Series Program is required.

My association will donate to the SCAEOP Professional Development Series Program in the amount of: *

If other is chosen, please list the amount below. *

Submit