CE Course Submission Form

Confirmation:

Upon receipt of this form, CAHU will email the requestor a confirmation that the course has been filed with the California Department of Insurance. If you do not receive a confirmation within 48-72 hours of your submission, please contact info@cahu.org.

Please Indicate to Request Type: *

New Filing Request

Change Previously Submitted Request

Cancel Filing Request

Contact Name: *

Contact Phone Number:

Contact Email: *

CE Package to be sent to: *

Company Name (if applicable): *

City, State, Zip: *

Local Chapter: *

CAHU will email you a confirmation when the course is submitted to DOI. Please Email Info@CAHU.org If you do not receive confirmation within 48 - 72 hours of filing this request

Course Number: *

Course Title: *

Is this panel discussion? If yes, more information may be requested:

Yes

Is the instructor on the CAHU approved speaker for this course? Click Here for the list of courses and speakers:

Yes

No. The speaker will be required to submit a DOI Instructor Qualification form. Please email info@cahu.org to request the form.

Instructor Name: *

CE Credit Hours: *