CM Partnership Single Event Activity Form

In order to apply for CM credit for your event, please fill out this form. If you have any questions please contact the GPA Professional Development Officer found on our Board Members page.

"*" indicates required fields

1CM / Session Info
2Presenter & Speaker Info
3Moderator's Info
MM slash DD slash YYYY
Time event begins*
Time event ends*
Please enter a number from 0 to 50.
Are you applying for*
Select all that apply
Point of contact (Name)*