ArkCDA Professional Development Event Application

Complete the form below and click the Submit Form button when finished. DATA ENTRY IS REQUIRED IN ALL FIELDS. If you are proposing multiple sessions you must complete and submit a separate form for each. To do so you may click the Back button on your browser after you have printed the page that displays once the form has been successfully sent. Then click the REFRESH or RELOAD button to update the Authentication Code. Finally, enter only the unique data for that event and click the Submit Form button. Repeat this process for each session. If you have any questions about this form or about the eligibility of an event please contact

*Today's Date (mm/dd/yyyy):
*Application Submitted by:

*Session Title:
*Focus Area:  
*Date of the Event (mm/dd/yyyy): *Location: *Hours (use numbers):

*I certify that this session meets the ADE criteria for professional development:
Verify Authentication Code: