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ASET Chapter Toolkit:
Guide to Conducting
an Educational Meeting
Conducting an Educational Meeting Page 2
Guide to Conducting an Educational Meeting
ASET-The Neurodiagnostic Society
402 East Bannister Road, Suite A
Kansas City, MO 64131-3019
816.931.1120 phone
816.931.1145 fax
www.aset.org
This Guide to Conducting an Educational Meeting has been developed to assist you
and your fellow neurodiagnostic technologists as you plan and host an educational
meeting.
ASET - The Neurodiagnostic Society is the largest national professional association
for individuals involved in the study and recording of electrical activity in the brain
and nervous system. Organized in 1959, ASET has grown to over 4,000 members.
ASET's mission is to provide leadership, advocacy and professional excellence for
our members, creating greater awareness of the profession and establishing
standards and best practices to ensure quality patient care.
Neurodiagnostics includes but is not limited to: Electroencephalography (EEG),
Evoked Potentials (EP), Nerve Conduction Studies (NCS), Polysomnography/Sleep
Technology, Intraoperative Neurophysiological Monitoring (IONM), Long Term
Monitoring (LTM), and Intensive Care Unit Continuous EEG Monitoring (ICU/cEEG).
This toolkit contains valuable information that will help you
host an educational meeting. The ASET staff is here to help
you as you plan and execute your educational event. If at
any time you have any questions about the material in this
manual or need an electronic copy of any documents in the
appendix, please contact Faye McNall at [email protected] or at
207-350-4087.
Conducting an Educational Meeting Page 3
Section One: Planning an Educational Meeting
1. Budget Development
2. Venue Selection 3. Program Development
4. Sponsorship 5. Continuing Education Credits 6. Marketing
Appendix List
A. Sample “To-Do” Spreadsheet
B. Meeting Income and Expense Spreadsheet C. Exhibitor/Sponsorship Registration Form D. Annual Conference Exhibitor Letter
E. Annual Conference Exhibitor Registration Form F. ASET-CEU Information Packet & Application
G. Conference Attendee Registration Form H. Sample “Save the Date” Notices I. Sample Registration List (for registration desk)
J. Sample CEU certificate
ASET-The Neurodiagnostic Society
Conducting an Educational Meeting Page 4
For many ASET chapters, education is one of their primary purposes. Meetings build
a sense of belonging and shared purpose and allow individuals who may be unable
to travel long distances to access educational offerings and grow as a
neurodiagnostic professional. Chapters may consider holding a business or
membership meeting in conjunction with an educational offering as well.
Planning a successful educational meeting can be somewhat intimidating to those
with no experience so it is helpful to try and identify someone in your group with
some background in meeting planning. Creating a Program Committee will allow
the multitude of tasks to be spread among several members and avoid over-
burdening any one individual. Some of the typical tasks to planning a meeting will
include:
Budget Development
Venue Evaluation/Selection
Program Planning
Sponsorship Opportunities
Continuing Education Credit Process
Marketing
Budget Development
The development of a meeting budget is a straight-forward process and initially one
of simple speculation. A simple meeting budget spreadsheet is included in the
Appendix.
One of the first steps in developing a meeting budget is determining the length of
the program (half day, one day, or two days, etc.) and the potential date(s) of the
meeting. Some research will prove worthwhile as you will want to avoid holidays
(including all religious holidays) as well as dates which conflict with other meetings
drawing from the same attendee or sponsor pool. In some areas you may want to
avoid dates of other local events (university ball games, festival dates, etc.).
Projecting likely attendance of your meeting is important to proper planning.
Estimating meeting attendance is a difficult, but vitally important task, particularly
for a first educational offering. Membership numbers can provide some guidance or
a short survey to assess interest may be helpful initially. Once a baseline
attendance is established (after one or two meetings) it will be much easier to
estimate your turnout.
Section One: Planning an Educational Meeting
Conducting an Educational Meeting Page 5
Setting registration fees is another important decision. Fees should ideally cover the
meeting expenses, with some profit to fund other organizational and educational
endeavors. The registration fees should be consistent with other similar
organizations and directly related to the number of meeting days (and number of
CEUs awarded). If the group is successful at obtaining sponsorship, fees may be
reduced, resulting in increased attendance. A tiered registration fee structure is
appropriate, with a member discount, differing fees based on ability to pay, i.e.
student versus physician, and/or cost to provide continuing education units and
date of registration (“early-bird” discount). Remember to factor in the cost of food
and any complimentary registration you may offer to exhibitors when setting your
registration fee schedule. Reimbursement of speaker travel expenses or speaker
honoraria will also be an important factor to consider.
Venue Selection
Chapters in their first years may be well served to organize their educational
offerings in a little-to-no-charge venue to keep expenses at a minimum. This may
be a hospital meeting space, a community room or even a restaurant. Look for a
meeting space which will accommodate the projected number of attendees.
Consider whether or not the meeting will include complimentary food (breakfast,
breaks and/or lunch) and how this will be provided (by the meeting facility or
outside catering). Attendees appreciate having food provided and this gives a
valuable additional opportunity for networking, but this will add significantly to
meeting expenses.
In later years, you will likely want to explore other venues for your meeting. Hotels
in larger cities offer meeting facilities, catering, rooming options and, possibly,
entertainment for your attendees. It is advisable that you contact two or three
different meeting facilities several months (or even a year or more) prior to your
proposed meeting date. Presenting multiple options to the board or membership
will allow them to participate in the selection of the meeting site. Some chapters
select a single, centralized location for all meetings, while others move from one
area of the state to another.
You will want to submit a “Request for Proposal” or RFP to your targeted meeting
sites. Many facilities will have their own form, often on their website, which can be
completed easily. Necessary information will include:
The name of your group
The proposed date(s) of your meeting
The number of anticipated attendees
Conducting an Educational Meeting Page 6
The number of hotel (sleeping) rooms you estimate being reserved (termed
the “room block”)
How many meeting rooms you will need and the desired set up
o Classroom
o Theater
o Hollow Square
o Crescent
Additional space needs for break-out sessions, receptions and/or exhibits
Audio-visual requirements (bringing your own projector may reduce
expenses)
Catering
o Breakfast
o Breaks
o Lunch
o Dinner
o Reception
The name and contact information for the meeting planner
Venue meeting planners can be very helpful before, during and after your meeting.
They have a wealth of experience and can help novice program committees avoid
common pitfalls. Your group may qualify for a reduced rate for accommodation but
keep in mind that if your society commits to a room block to qualify for reduced
rates a percentage of any unsold rooms will likely be billed to the group master
account. Be sure to inquire about complimentary rooms if your attendance reaches
a certain level—these can be used for the President, the meeting planner, or a
speaker. Any additional costs to the group or attendees should be stated clearly
and up front (parking fees, resort fees, etc.).
If you are signing a contract for the meeting venue, be sure the appropriate person,
generally the President or Treasurer, signs the agreement but ONLY after carefully
reviewing it and confirming all the details are correct. And don’t hesitate to
negotiate the terms of the contract. Venues are anxious for your business and may
reduce catering costs, provide complimentary meeting rooms or audiovisual
equipment or add other “perks”.
Program Development
State and local chapters generally use “volunteer” speakers from the local
community who do not require an honorarium or have significant travel expenses.
Industry speakers are also a valuable resource but conflicts of interest must be
clearly disclosed to the attendees and to the organization granting educational
credits. These speakers often have a depth of knowledge regarding certain aspects
Conducting an Educational Meeting Page 7
of the field of neurodiagnostic technology but care should be taken that no one
company is given an advantage by presenting to the group. In addition, speakers
on topics relevant to, although not directly connected to, neurodiagnostic
technology can be extremely effective. Topics such as stress or time management,
governmental regulation or related health subjects can be effectively presented by
local experts at minimal cost.
Assign one or two person(s) to moderate the meetings. They are responsible for:
Making announcements to the attendees
Introducing the speakers
Keeping sessions on time
You will also need at least two people to staff the registration desk and assist with
sign-in sheets for continuing education credits.
Sponsorship
Industry sponsorship can be a vital component of a successful meeting. Consider
setting aside space (and time) for exhibits, applying for educational grants or
offering time for sponsored social events or sessions. Vendors may also provide
“giveaways” for your registration packet, such as ink pens, tablets, lanyards, etc.
Industry representatives are always looking for the most effective way to meet
their customers and a state chapter meeting brings together many of their “hard to
find” consumers in one place at the same time. Make sure to remind attendees to
thank those industry representatives who attend.
Keep your industry supporters informed about your future meeting plans.
Frequently budgets for representatives are made well in advance. You should
develop a letter or information packet for your vendors to let them know exactly
what they are signing up for, for example:
Date(s) of the meeting
o Available dates/times for industry sponsored events
o Desired lecture topics/speakers for industry sponsored lectures
o Exhibit set up and tear down date/time
Exhibit space details
o Their cost for exhibit space
o What amenities are provided (table, chairs, electrical outlets, table
covers)
o Whether admission to the lectures (with or without CEUs) is
complimentary and for how many vendor representatives
Conducting an Educational Meeting Page 8
o Hours when the attendees will be free to visit the exhibitors
o Whether or not vendors will be included in meals or not
A sample vendor letter and registration form is included in the Appendix.
Continuing Education Credits
Continuing education credits are the primary reason for many of your potential
attendees to register for your event. For neurodiagnostic professionals, ASET can
approve credits, designated ASET-CEU credits, which will be accepted for
maintaining of ABRET credentials. Review the ASET-CEU credit procedure on the
ASET website well in advance of your meeting date. You may find the details at:
http://www.aset.org/i4a/pages/index.cfm?pageid=3404#CEUs_that_count
The application will require:
A fee for processing applications
A copy of the final program, including:
o Date
o Location
o Speakers and topics
o A conflict of interest statement from each speaker
An evaluation form for each presentation
A final list of attendees and credits
The ASET-CEU credit application form may be found at:
https://www.aset.org/files/public/ASET-
CEUsApplyPacket2017_Revised_Interactive.pdf
The chapter will return the following to the ASET Executive Office within three
weeks of completing the program: the ASET-CEU attendance roster; a completed
Program Director's Summary and evaluation form and a summary of the participant
evaluations. The chapter should retain a copy of the records from the educational
meetings.
If you plan to provide Continuing Medical Education (CME) credits for physician you
will need to apply to an educational institution, such as a local university. Keep in
mind that while this process can be rather arduous and is typically more expensive
than CEU provision, it may be worth the expense if it draws physicians to your
meeting.
Consider how you will provide the CEU/CME certificates to your attendees. When
feasible, attendees appreciate certificates being available at the conclusion of the
Conducting an Educational Meeting Page 9
meeting but this will require some additional work while at the meeting site. Keep
in mind that the chapter is responsible for maintaining attendance records and
providing copies of certificates for several years after the conclusion of the meeting.
Marketing
It is important to market your meeting in an effective manner. Initially, “Save-The-
Date” notices sent well in advance will allow attendees to make plans to attend.
Again, your industry representatives are a valuable resource in spreading the word
about upcoming meetings. If you have a website, meeting information should be
easily visible and accessed there. The ASET website will list your meeting at no cost
to you in its online calendar of events.
Event flyers can easily be created by anyone with a little creativity and experience
in Microsoft Word or Publisher. Be sure to include the following details:
Program name, date(s), time, location
Directions to the meeting venue and the cost and deadlines for reserving
hotel accommodations
The name of the meeting room(s)
Speaker & topic information
Agenda
Name and contact for additional information
Fees and registration form with person/address where the form and fee
should be returned as well as the acceptable method(s) of payment (cash,
check, credit card, on-line payments, etc.)
Cancellation policy
If you plan any prize drawings, raffles or door prizes, include this information in
your flyer.
ASET Educational Offerings
The following are educational offerings that ASET makes available to developing
and affiliated chapters. The John Knott Educational Lecture Program is only
available for established chapters, the Speaker Bureau and Webinar Recordings are
available for both developing and established chapters. We hope you will find these
offerings beneficial in your future educational programming.
Speaker Bureau
ASET has a large database of speakers and topics covering all modalities of
neurodiagnostics, and all expertise levels and practice areas of your
Conducting an Educational Meeting Page 10
audience. To learn more about this resource please contact ASET’s Education
Office and ASET’s Director of Education Faye McNall, Med, R. EEG. T at
[email protected] or 816-944-3236 for leads or suggestions.
Free Webinar Recordings
ASET is pleased to offer your neurodiagnostic chapter three free webinar
recordings each calendar year for use at your chapter-sponsored education
events. For example, the recordings could be used as sessions at your annual
meeting, part of a lecture series that may be offered by your chapter, or a
special program add-on to your membership or business meeting. Please
note that the webinar recordings can only be used at your chapter’s non-
virtual events, i.e. you may not load the content on your website for viewing
or download by your members.
To view the webinar recording topics available for you to choose from, visit
http://www.aset.org/i4a/ams/amsstore/store.cfm?product_id=0 on the ASET
website. Then in the “Category Browse” box select “Webinar Recordings…..”
To request your free recordings, the designated chapter representative
should contact Olivia Cottingham, ASET’s Registration & CEU Manager, at
[email protected] or 816-931-1120, ext. 102, and reference the title and item
# of the recording(s) you are requesting. Note that you do not need to
request all three recordings at the same time. You may spread your requests
throughout the calendar year to best suit your programming and topic needs.
John Knott Educational Lecture Program
Originally conceived by Albert Grass and John Knott, the ASET Foundation’s
John Knott Educational Lecture Program is a lecture series designed to bring
distinguished speakers to an area chapter meeting, thereby providing
exceptional educational opportunities for technologists who might be unable
to attend the national meetings. Chapters representing the interests of
neurodiagnostic technologists are eligible for the opportunity to host a Knott
Lecture. To be considered to host a Knott Lecturer, all your chapter needs to
do is complete a Request for Lecture Form in full and return to Faye McNall,
ASET Director of Education. More information the program and the Request
for Lecture Form can be found at: http://www.asetfoundation.org/special-
programs/john-knott-educational-lecture/
Appendix A-Sample "To Do" Spreadsheet
TASK ASSIGNED TO STATUSHotel contractCatering and event forms reviewed/edited/returned to venueFinal head count for cateringSave the Date notice sentProgram completePut together speaker introductions (and do the introductions)CME application doneRegistration materials / membership applications sent outChanges to room block evaluated/form sent to resortCatering/AV order reviewed with resort and signed off onHard copy of meeting brochure/membership forms printedFold, stuff, mail hard copy of registration materials/membershipPrepare registration/membership forms for on-site registrationGather supplies for registration desk (pens, stapler, ?printer, etc)Complete application for CMEPrint CME forms for MDs to complete/sign at registrationComplete application for CEUsPrint sign in sheets for CEUsPrint speaker evaluation formsCompile summary of speaker evaluations for AASTCompile attendee list for AASTPrint and distribute CEU certificatesGet handouts from speakersPost handouts on websiteNotify attendees of handouts posted on websitePrint handoutsPrint programsPurchase folders (or whatever we are going to use) for handoutsPurchase supplies for nametagsPrint nametagsFind someone to work at registration deskPrint list of paid/registered attendees for registration deskPrint list of paid/registered vendorsPrepare checks for speaker honorarium Signs for registration desk, vendor room, etc.Print signs acknowledging sponsorship of mealsMake slide(s) to run during breaks with sponsor thank-youPrint lunch/dinner ticketsAssemble/print agenda for board meetingPut together board packetsNotify board members of date/time of board meetingAssemble agenda for Membership/Business meetingPut together Treasurers report for Business meetingPut together RFP's for next year's meeting for attendees to vote on
Conducting an Educational Meeting
Appendix B-Meeting Income and Expense Spreadsheet
EDUCATION MEETING INCOME
DESCRIPTION # TOTAL INCOMERegistration fees $0.00
Exhibit space fees $0.00
Sponsored meals $0.00
Breakfast $0.00
Lunch $0.00
Dinner $0.00
Breaks $0.00
Donations
TOTAL MEETING INCOME $0.00
EDUCATION MEETING EXPENSES
DESCRIPTION # TOTAL COSTRoom rental per day $0.00
Audio-visual $0.00
LCD projector $0.00
Projection screen $0.00
Hand held microphone $0.00
Lavalier microphone $0.00
Laser pointer $0.00
Wireless internet access $0.00
AV support/labor $0.00
Catering $0.00
Continental breakfast $0.00
Breaks $0.00
Lunch $0.00
Dinner $0.00
Reception $0.00
Speaker expenses $0.00
Travel $0.00
Accommodations $0.00
Honorarium $0.00
Speaker gifts $0.00
CEU application fees $0.00
CME application fees $0.00
Printing $0.00
Save the date notices $0.00
Registration materials/program $0.00
CEU certificates $0.00
Handouts $0.00
Name badges $0.00
Postage $0.00
Save the date notices $0.00
Registration materials/program $0.00
CEU certificates $0.00
Attendee gifts (bags, pens, etc) $0.00
Signage $0.00
Misc meeting materials $0.00
TOTAL MEETING EXPENSES $0.00
INCOME OVER/(UNDER) EXPENSE $0.00
Conducting an Educational Meeting
Appendix C-Exhibitor/Sponsorship Registration Form
(Name of meeting)
(Date(s) of meeting)
(Location of meeting)
CONTACT PERSON:
PHONE:
FAX:
E-MAIL:
PHONE:
FAX:
E-MAIL:
EXHIBIT FEE (cost of exhibit space) Includes:
*Use this space to outline the details of your exhibit and sponsorship opportunities. If you are offering booths for rent
(8 x 10 & 10 x 10) provide all the details on the different sizes and cost and what exactly is included (i.e., table, number
of chairs, trash can, electricity). If you are offering tabletop space describe the different sizes, and cost and what
exactly is included. If exhibitors will be receiving one or more complimentary registrations make sure and include
this information as well. Provide details on the cost of registration information for additional exhibitor personnel and
the associated fees. Consider providing an early bird discount for exhibit sign-up and payment prior to a specific date.
MEAL SPONSORSHIP (check meal you wish to sponsor)
Friday continental breakfast (price)
Friday morning break (price)
Friday lunch buffet (price)
Friday afternoon break (price)
Friday dinner (price)
Saturday continental breakfast (price)
Saturday morning break (price)
Saturday lunch buffet (price)
Space is limited. Please reserve early by contacting: (name of contact person)
(address of contact person)
Phone: Reg rec'd
FAX: Pmt rec'd
E-Mail: Ck #
The (name of group) is a 501c 6 (or appropriate designation) organization.
Tax ID: (enter EIN)
(Logo or name of group)
COMPANY NAME:
ATTENDING REPRESENTATIVE
FOR SOCIETY USE ONLY
Conducting an Educational Meeting
Appendix D- Annual Conference Exhibitor Letter
Conducting an Educational Meeting
Dear Colleague, (ST) Chapter of ASET – The Neurodiagnostic Society invites you to exhibit at the 20## (ST) Chapter Annual Conference on Month Date(s), 20## at the LOCATION in City, State. We are anticipating more than ## neurodiagnostic technologists, students, physicians, other healthcare providers. Join us for one of the premier educational and networking event for all disciplines of neurodiagnostics, including EEG, EPs, Intraoperative Neuromonitoring, Long-Term and ICU Monitoring, Nerve Conduction Studies, Polysomnograpy/Sleep, Neurodiagnostic lab management and Neurodiagnostic education. This year’s conference, Name/Theme, promises to be a great resource for your products and services to be presented to qualified neurodiagnostic professionals. We would like to remind you that there is still time to take advantage of the early-bird exhibitor rates before the Month/Date/20## deadline. Early-Bird Rates 10 x 10 - $$$ 10 x 20 - $$$ 10 x 30 - $$$ The exhibit hall will be open on DAY, Month Date and DAY, Month Date. I’ve attached an Exhibitor Prospectus and added a few links below for additional information. Insert link to Hotel Information Insert Floor Plan if available Exhibit space is reserved by completing the contract and returning it to the (ST) Chapter at (address/fax). Space is available on a first-come, first-serve basis. For your convenience, I have also created an online form. Insert link to Online Form As always, please let me know if you have any questions. I look forward to seeing you in City! Thank you,
Appendix E-Annual Conference Exhibitor Registration Form
Conducting an Educational Meeting
A d d L o g o 2 0 # # ( ST ) C h a p t e r o f A SE T A n n u a l C on f e r e n c e
M o n t h D a t e C i t y , S t a t e
Exhibitor Registration [Return by Month Date, 20##]
Exhibitor Name Badge Form
Company ________________________________________________________ Name______________________________________________________
Primary Contact? Yes No [Primary contact will receive opening reception tickets.] Nickname for Badge ___________________________________________ Mailing address ________________________________________________________________________________________________________________ City ___________________________________ State/Province ________________ Zip Code/Postal Code _____________________________ Daytime phone number (_______) _____________________________ E-mail* ________________________________________________________ If no box is checked, your contact information as listed above will be published in the attendance list My information as shown My information as shown, except email My information should not be released Each (Size) booth gets # complimentary Full #-Day registrations, which includes the Reception on DAY evening, a final program, and access to conference proceedings, ACE credits, and lunches DAY, and DAY. Please register all booth personnel for this event, one registrant per form. This form also serves as your name badge form. If you plan to attend courses and want to receive ACE credits, you will need to make copies of this form and pre-register as well. Please note, that exhibitors have been given a discount off registration fees or one free registration with CEUs. Confirmation of registration will be sent to the above e-mail address. Check Appropriate Category Fees Complimentary Full #-Day Exhibitor Registration Complimentary Additional Booth Personnel $$$ [Opening Reception, DAYS. registration only – no ACE Credits awarded and lunch included] Full #-day Registration [DAY – DAY] $$$ [Includes Welcome Reception, lunches, breaks and handouts] One Day Only [only one day can be checked for this category] DAY [Includes lunch, breaks and course handouts] $$$ DAY [Includes lunch, breaks and course handouts] $$$ Any other event $$$ Total Amount $ _________
Cancellation Policies All cancellations must be made in writing and can be mailed, faxed or e-mailed to the CONTACT INFO. Registration fees, less a $50 processing fee may be refundable if written notice is received by the (ST) Chapter of ASET Executive Office by DAY, MONTH DATE, 20##. There will be no refunds for cancellations received after DAY, MONTH DATE, 20##. Payment Information Check or Money Order payable to: (ST) Chapter of ASET [U.S. dollars only]
American Express Discover MasterCard Visa PayPal Name on Card_____________________________________________________________________________
Account No _____-_____-_____-_____
Expiration Date________ / ________ 3 / 4 digit security code_____________ Zip Code____________ Month Year
Cardholder Signature_______________________________________________________________________
Return to: (ST) Chapter of ASET Address City, ST ZIP ###.###.#### phone ###.###.#### fax
Updated 12/29/2016
2017 ASET-CEUs Information Packet & Application
Education programs are eligible for ASET Continuing Education Units provided that: The content is relevant to the field of neurodiagnostics;
The program is presented in an organized learning format and includes a printed schedule with dates, times, speaker and their credentials; Faculty or product authors must have the appropriate professional credential for the topic being presented;
The objectives of the program are stated and adhered to; The sponsoring organization assumes responsibility for the program, including capable
direction, qualified instruction, and documented attendance;
The program is evaluated by the participants and organizers;
The event hasn’t taken place yet.
Programs which are not eligible for ASET-CEUs include: Equipment in service and training sessions;
Mandatory and/or standard employee training for on-boarding purposes. This includes employer provided didactic course work and vocational training at the onset of employment for the primary purpose of preparing employees to perform one’s duties.
Classroom activities such as required reading, notes, flashcards, quizzes, or non-neurodiagnostic related training such as HIPAA, CPR, or facility tours, etc.
Events that have already taken place. ASET does not award ASET-CEUs retro-actively and the applications will not even be considered;
Incomplete applications and those received without payment of the appropriate fee will be returned to the sponsoring organization.
Steps to Award ASET-CEUs
30 days before the event: mail ASET payment and forms 1 and 2 (program’s title, sponsor and credit card information) and form 3 (schedule of the event). 1) ASET will send you notification of the number of credits along with ASET-CEUs Rosters and
evaluation forms via email. 2) After the education event, the program director will make sure all ASET-CEUs Rosters and
evaluation forms are complete and will return them to the ASET Office. Applicants whose names are il legible or whose information is incomplete will NOT receive ASET-CEUs.
3) ASET imports the records of all participants entered on the ASET-CEUs Roster and Excel spreadsheet after verifying the data with the sign-in sheet into the ASET-CEUs database for education credits if the data is complete, including complete mailing addresses for each participant.
Forms 1 & 2 - Prepare the appropriate payment as outlined in the ASET-CEUs Fee Schedule The fee charged for the awarding and recording of education credits is based on the sponsorship of the program. A check [made payable to ASET] for the appropriate amount must accompany the request for ASET-CEUs. Credit card payment is avai lable on the form. Appl icat ions without fee payment wi l l not be considered. Form 3 - Complete the Program Time Schedule Please provide all of the information requested on the form. This form will provide an outline of your program to assist in determining the number of ASET-CEUs that ASET will assign. A copy of your printed schedule can be substituted if all of the requested information is included. All breaks and lunch periods must be stated as well.
Mail the completed forms and ASET-CEUs fee to: Olivia Cottingham, ASET, Registration and CEU Manager, 402 East Bannister Road, Suite A, Kansas City, MO 64131-3019. Phone: 816.931.1120, Fax: 816.931.1145, Email: [email protected]
Updated 12/29/2016
ASET-CEUs Request Form
The Credit Request Form must include payment of the application fee and be mailed, faxed or scanned and emailed to the ASET Executive Office 30 days prior to the start of the program. This form may be reproduced as needed.
A. SPONSOR IDENTIFICATION
1. Sponsor ing Organizat ion:_________________________________________________________
2. Program Director:________________________________________________________________
Mailing Address:________________________________________________________________________
City and State:_______________________________________________________ Zip _____________ [Confirmation of credits will be sent to the Program Director unless otherwise specified.]
Business (_________)___________________ Home (_______)________________ Fax (_______)_______________
E-mail _____________________________________________
B. PROGRAM INFORMATION
1. Type of Program - Select one: Select one:
State, local, or regional Society Meeting/Course Self Study Product
National Society or Association Single Lecture Live webinar
Hospital or University Lecture Series Recorded webinar
Company or Independent Sponsor Online Course
2. Program Tit le: ________________________________________________________________________
_________________________________________________________________________________________
3. Program Date and Location: [Please attach a sheet with additional dates and locations, if
necessary.]
Date Starting Date Ending City and State
4. Summary of Program Content:
Form 1
Form 2
Updated 12/29/2016
5. Teaching Methods to be Util ized [select all those that apply]: Lecture W o r k s h o p M e d i a / V i d e o Cl i n i c a l S i t e s C o m p ut e r Other
6. Total Number of ASET-CEUs requested _______________________________________________
[1 ASET-CEUs is awarded for each hour of lecture time]
7. Ant ic ipat ed At t endance: _____________ 8. Participant Fees or Tuition: $ ________________
C. RESPONSIBILITY Should this program be approved by ASET for ASET-CEUs the undersigned, on
behalf of the sponsor[s], agree to:
1. Assure that the program described herein is conducted as proposed;
2. Conscientiously maintain the ASET-CEUs Attendance Roster on-s ite during the educat ion
event;
3. Print the following disclaimer in full on program information and schedule s:
“ASET - The Neurodiagnostic Society has granted ASET Continuing Education Units
[ASET-CEUs] for this program. Such crediting, however, should not be construed by
program part icipants as an endorsement of any type of instruments or supplies
mentioned or involved in these presentations."
4. Return the following to the ASET Executive Office within 3 weeks of completing the program:
The ASET-CEUs Attendance Roster. A completed Program Director's Summary and Evaluation form and a summary of the
participant evaluations.
Signature of Program Director / Contact Person Date of Application
Payment Information**
Refer to the Fee Schedule on page 5. A $50 late fee will be assessed if the ASET-CEUs application is received
less than 30 days from the start of the program, unless otherwise noted.
Check/money order [payable in US funds only]
American Express Discover Mastercard Visa
Name on Card: ________________________________________ E-mail: ________________________________
Account No_______________ - __________________ - _________________ - ______________________
Expiration Date _______/__________ 3 / 4 digit security code __________ Zip Code ___________
Month Year
Cardholder Signature_____________________________________________________________________
Total Amount Due: $ ___________________
**Please note that payment will be processed upon receipt. Paperwork will go through the approval process
and final approval notification will be sent out. Please copy the completed questionnaire [for your
records] and return the original with the appropriate fee to:
Olivia Cottingham, ASET, Registration and CEU Manager
402 East Bannister Road, Suite A, Kansas City, MO 64131-3019
816.931.1120 • 816.931.1145 • [email protected]
Form 3
Updated 12/29/2016
Program Time Schedule
[Must accompany the ASET-CEUs Request Form]
Please complete all sections in order (list the first talk first and the last talk last) and include
scheduled breaks and meal times. A copy of your printed schedule can substitute this form provided
that all of the information is included.
DATE START TIME END TIME TOPIC SPEAKER NAME SPEAKER CREDENTIALS
Example: 03/12/2010
8:30 am 5:00 pm Neuroanatomy Sue Smith BS, R EEG/EP T.
Please also note that credit hours are awarded per day. If your program is one day in length, all
instructional minutes are added together to give the total hours awarded for that day. If your
program is two or more days in length, DO NOT add all minutes from every day and then divide by 60 ...
determine hours on a daily basis.
Updated 12/29/2016
ASET-CEUs Fee Schedule*
A $50 late fee will be assessed if the ASET-CEUs application is received less than 30 days from the start of the
program, unless otherwise noted.
Submiss ion of the ASET-CEUs Request Form must be accompanied wi th the appropr iate fee as
outl ined below before the awarding of education credits wi l l be consi dered.
The following fees apply for single seated day programs covering one 8 hr day*:
LOCAL, STATE AND REGIONAL SOCIETIES $75
[NEW DEFINITION REQUIRED - a single state or city-based society, or area within the state group]
NATIONAL SOCIETIES, HOSPITALS, UNIVERSITIES $100
COMPANY OR INDEPENDENT SPONSORS $150
*For two or more course days, add $50 per day.
LECTURE SERIES [approval is for a 12-month period] - These fees apply to 1– 2 hour lectures
presented in a series.
Definition of Lecture Series: A complete program of regularly scheduled, in-service lectures held
on a weekly or monthly basis with an established faculty [example: neuroanatomy series,
record review]. Attendance rosters should be completed for each lecture and submitted at
the end of the 12-month period. This category does not apply to a program of lectures that is
repeated within a six-month period.
WEEKLY SERIES [up to 52 per year]:
Hospital, University, National Society: $400/yr Company/Independent Sponsor: $550/yr
MONTHLY SERIES [12 per year]:
Hospital, University, National Society: $250/yr Company/Independent Sponsor: $350/yr
SINGLE LECTURES – Seated programs [up to two hours in duration]: $40
PROFESSIONAL END EDUCATORS: $750/yr
For independent educator companies offering courses on various topics up to 10/year
For additional courses over 10 per year - $50/ea
SELF STUDY PRODUCTS:
One time design product [CD or DVD] $350/product
Post test must be submitted along with outline of information on CD or DVD
One On-line course (appendix A) $500/yr/course
[Will require two month’s time for approval and requires separate ASET-CEUS credit application
and a yearly renewal fee and a 5 year re-evaluation fee – see Appendix B]
WEBINAR: Priced in 2 hour intervals
Live Webinar – not recorded [up to two hours in duration requires documentation of participation]: $40.00
Recorded Webinar - Requires submission of a post test and yearly renewal fee - see Appendix B: $100.00
Updated 12/29/2016
APPENDIX A
ASET-CEUs Application for on-line courses
This form is to be used only when applying for ASET-CEUs for an on-line course, to provide
information that will help us determine the number of ASET-CEUs to be awarded. It may take up to
two months to complete the assessment process for on-line courses and award the appropriate
number of ASET-CEUs. All online courses must be re-evaluated after 5 years for course material
validity. A fee of $50.00 will apply.
A $50 late fee will be assessed if the ASET-CEUs application is received less than 2 months from the
start of the online education program.
Items required:
Syllabus, lesson plan, or course outline which lists course content
Copy of all assessment tools used within the course: quizzes, exams, assignments, etc.
Reading list if outside articles are part of the course
Evidence of a student evaluation tool – a copy of a form provided to students to provide
feedback upon completion of the course.
2 letters, one from each of two individuals, in the END field, who have taken the course,
as reviewers/pilot users, to document the number of hours it took for each of them to read all of
the course material, complete all assignments and take all exams. The applicant should
select reviewers with a background similar to the target audience for the course. The
letters must include the qualifications and work experience of the individuals, and
documentation that they were able to pass all exams imbedded in the course. These
reviewers wil l automatically be awarded the designated number of ASET-CEUs awarded.
ASET reserves the r ight to appoint an independent reviewer to provide additional
assessment and will request that the course author allow the reviewer access to the course,
should this situation arise.
Name of the course: ___________________________________________________________________________________________
List all course authors and their credentials: _____________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ Please attach all of the above listed items, along with payment, and send to:
ASET Executive Office
402 East Bannister Road, Suite A
Kansas City, MO 64131-3019
816.931.1120
816.931.1145 (Fax)
For questions about this process please contact Faye Mc Nall, Director of Education:
207.350.4087; [email protected]
Updated 12/29/2016
ASET-CEUs Approved Program Renewal Form
This form is to be used only when renewing an on-going, pre-approved program for ASET-CEUs credits. Upon renewal, please submit any changes in content material. All material must comply with AES and ASET competencies. Please check applicable renewal/re-evaluation program:
Online course - $100.00 yearly renewal fee
Company____________________________________ Course Title: _________________________________________________
Online course - $50.00 5-year re-evaluation fee
Company____________________________________ Course Title: _________________________________________________
Recorded Webinar - $50.00 yearly renewal fee
Company____________________________________ Webinar Title: ________________________________________________
Signature of Program Director / Contact Person Date of Renewal Form
Payment Information
Check/money order [payable in US funds only]
American Express Discover Mastercard Visa Name on Card: ________________________________________ E-mail: ________________________________ Account No_______________ - __________________ - _________________ - ______________________
Expiration Date _______/__________ 3 / 4 digit security code __________ Zip Code ___________ Month Year
Cardholder Signature_____________________________________ Total Amount Due: $______________ Items required if there is a change in content material:
Syllabus, lesson plan, or course outline which lists course content
Copy of all assessment tools used within the course: quizzes, exams, assignments, etc.
Reading list if outside articles are part of the course
Evidence of a student evaluation tool – a copy of a form provided to students to provide
feedback upon completion of the course.
2 letters, one from each of two individuals, in the Neurodiagnostic field, who have taken the
course, as reviewers/pilot users, to document the number of hours it took for each of them to read
all of the course material, complete all assignments and take all exams. The applicant should
select reviewers with a background similar to the target audience for the course. The letters
must include the qualifications and work experience of the individuals, and documentat ion
that they were able to pass all exams imbedded in the course. These reviewers wil l
automatically be awarded the designated number of ASET-CEUs credits awarded. ASET
reserves the r ight to appoint an independent reviewer to provide additional assessment and
will request that the course author allow the reviewer access to the course, should this situation
arise. Please attach all of the above listed items, along with payment, and send to: ASET Executive Office, 402 East Bannister Road, Suite A, Kansas City, MO 64131-3019.
For questions about this process please contact Faye Mc Nall, Director of Education: 207.350.4087;
APPENDIX B
Appendix G-Conference Attendee Registration Form(Name of society) (Logo if available)
(Name of event)
(Date/s of event)
(Location)
Items marked with asterisk (*) are required
*First Name:________________________________________________ *Last Name:___________________________________ Credentials:_______________
*Street Address:_______________________________________________________________________________________________________________
*City:______________________________________________________*State:_______________________________________ *Zip:______________________
*Phone (with area code):____________________________________ Alternate phone:_________________________________________________________
E-mail address:________________________________________________________________________________________________________________
*Emergency contact name:__________________________________Emergency contact phone number:________________________________________
REGISTRATION FEES Cancellation policy:
Before (date) After (date) (add information on refunds, etc.)
Full day fee
Member $ (consider reduced rate for early registration)
Non-member $ (consider add'tl fee for on-site registration)
(consider reduced fee for students with faculty confirmation)
Half day fee (consider guest/spouse registration)
Member $
Non-member $
Special requests:________________________________________________________
TOTAL ENCLOSED:_______________________(make check payable to: (ST Chapter of ASET)
(consider possible payment options--credit cards or PayPal?)
Return completed registration form with payment to: For additional information contact:
(Name of responsible officer) (Name of responsible officer)
(Address of responsible officer) (Phone number of responsible officer)
(E-mail of responsible officer)
Conducting an Educational Meeting
J
Join us in sunny Orlando
Florida September 20-22, 2012 for our 52nd annual meeting along with
the newly formed Florida Neurodiagnostic society!
Sleep, IOM and EEG courses with ASET-CEU credits from ASET and
CEC from BRPT awarded
Two hour Board Prep Courses in EEG and IOM Thursday Night
(credits-2)
”Meet and Greet” with refreshments provided Thursday evening in
SSET President’s Suite
Free Social Friday night! Please visit sset.org for more info-online
registration .
Appendix I-Sample Registration List
First Name Last Name Credentials Degrees Nickname Company Address1 Address2 City State Zip Phone Fax
Robert Johnson R. EEG/EP T., CLTM Bob Johnson Neurology 1665 Bluebird Drive Galesburg IL 61401 309-343-0000 309-343-0001
Mary Amith RPSGT AS Community Hospital 8168 37th Ave Phoenix AZ 85037 623-329-0000 623-329-0001
Stan Jones BS Jones Medical Supplies 201 N. Main St. Kansas City MO 64131 816-931-0000 816-931-0001
Conducting an Educational Meeting
Appendix I-Sample Registration List
Email MemberType Order Total RegisteredEvents Date Posted In case of emergency Special Request
[email protected] Active Member 125.00$ Full 2-Day [Fri - Sat] (Member ) 6/12/2012 Karen Johnson 309-343-0002
[email protected] Active Member 125.00$ Full 2-Day [Fri - Sat] (Member ) 6/20/2012 Bob Smith at 623-329-0002 Vegetarian meal
[email protected] Corporate 300.00$ Exhibitor (Exhibitor Full 3-Days) 7/6/2012
Conducting an Educational Meeting
(ST) Chapter of ASET (Name of Event)
Month Date(s), 20## City, State
Certificate of Completion Presented to
_____________________________
This attests that the bearer of this certificate has completed (ST) Chapter of ASET’s:
Essentials and Updates in EEG Technology
## ASET CEU Credits are awarded for completion of this course.
Logo Name, Credentials
(ST) Chapter of ASET President
