The individual or entity seeking approval of a course shall provide the following information on the “Request for Continuing Education Course Approval” form issued by the board or on separate attachments:

1. (a) The name, address, email, and phone number of the person making the request;
2. (b) An indication as to whether the requester is a provider or student, and whether the request is for pre-approval or approval of a course;
3. (c) The name of the sponsor of the program;
4. (d) The date, time, and location of the course;
5. (e) A summary of the professional qualifications of the person or persons presenting the course, including specifics required under Fam 404.07;
6. (f) The required topic or additional topic for which approval is sought;
7. (g) The duration of the course, excluding meals and breaks. If the request is for the total number of credits to be allocated in multiple continuing education topics not including a hybrid course under Fam 404.08(c), then an agenda or other verification of time spent on each topic for which credit is being requested shall be attached;
8. (h) A brief description of any experiential component included in the program, including the length of such components;

9. (i) A description of how the course will:

   1. (1) Update or enhance certified family mediators’ knowledge of families and family law;
   2. (2) Improve the professional competence of the mediators; or
   3. (3) Equip mediators to work effectively within ethical boundaries; and
10. (j) Any written handouts provided at the course, if available.

Source. #12635, eff 10-2-18; ss by #12988, eff 2-6-20 (formerly Fam 404.09)