General/Student CE March 7, 2018

For general participants not seeking CE credit (students, paraprofessionals, other health professions)

  1. General Sign In Sheet or  Online Sign In Sheet (select applicable profession or student)
  2. Participant Profile – March 7 (downloadable)  OR Participant Profile online version
  3. Evaluation – March 7 downloadable copy OR Program Evaluation Online Version
  4. AGEC Certificate – print and keep (certificate is not valid until we received items 1-3 of required document listed above) 

In order to receive AGEC contact hours, this documents listed above Must be filled out completely, and returned to the facility coordinator, upon check out, on the day of the event.


Online or offsite participants MUST email this form to, or fax this form to 501-603-1966, within 5 business days of the event.  All other required paperwork must also be completed online or emailed/faxed with this CE form to receive credit.  All paperwork must be submitted within 5 working days of the seminar to receive CE Credit.

AGEC Contact Information:

4301 W. Markham St., #798

Little Rock, AR 72205

TEL: 501-603-1969

FAX: 501-603-1966