PRIVATE PROCESS SERVER PROGRAM
APPLICATION FOR COURSE ACCREDITATION
Provider/Course Sponsor Information
Name of Sponsor
Street Address
City
Zip Code
Telephone # Fax # Email
Course Information
Course Title
Date and Time
Location
Proposed number of Continuing Education
Credit Hours (Select from drop down box)
Course Content
Course
Objectives
Evaluation
Method
Presenter(s)
State
Proposed Audience
Outline of Course Presentation
Topic Covered Learning Objective & Teaching Method Time Allocated
**A copy of this document may be used as the required "Time Allocation Form" for courses that are 8
hours or longer.
DOCUMENTATION:
The following documents MUST be submitted with your proposal. Failure to provide these materials with the
application will result in denial of application.
Faculty qualifications (resume, curriculum vitae, etc.)
A copy of all written course materials to be provided to the participants
Copy of the examination with answer key (if applicable)
In signing and submitting this document, the sponsor agrees to assume responsibility for verifying attendance of the
participants, will provide a certificate of attendance for each participant who successfully completes the activity including a
time allocation document for any courses 8 hours or longer, and will provide any additional information requested to assist the
Administrative Office of the Courts in evaluating this proposal.
A signed Application for Course Accreditation with all sections
completed.
Signature of Sponsor Date
Private Process Server Program staff approval of this application signifies only that the information provided by the sponsor in
the application is compliant with the continuing education requirements for certified private process servers in the state of
Arizona. Continuing education courses are approved for the intended purpose of fulfillment of the continuing education
requirements for Arizona certified private process servers only, as provided for in ACJA
§ 7-204(L). Approval of the course
should not be assumed as an endorsement of the course sponsor, the faculty or the content presented.
Approval: Administrative Office of the Courts
Private Process Server Program
Date
Submit this application with the required documentation to:
Private Process Server Program
Administrative Office of the Courts, Certification and Licensing Division
1501 West Washington, Suite 104
Phoenix, AZ 85007