Registration for Winter 2022 Hospice & Palliative Care CPE Unit

REGISTER HERE ONLY IF YOU HAVE APPLIED AND BEEN ACCEPTED INTO THIS UNIT.

Name

First Name

Last Name

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is your faith tradition?

What is your title within your faith tradition?

What is your highest degree earned and what is it in?

Have you taken previous CPE Units with SLCET?

Yes

No

If you have taken previous CPE with SLCET or another Training Center, how many units have you taken?

1

2

3

4

More than 4