Title
Request for Teacher
Continuing Education Unit (CEU)
For Minnesota Department of Education online trainings only
District Name: District Number
Training Information
Training location:
Street Address:
City: State: Zip:
Complete as many forms as needed to include all training participants.
Participant First/Last Name
Training Title
as it appears on the MDE Website
Training Date
School/District verifying participant involvement
Email Phone
Signature of school/district administrator verifying participant involvement
Send your completed form to Karen Reiter, karen.reiter@state.mn.us for processing. CEU certificates for each
participant listed will be returned to you. If you have any questions about this process, please contact Karen
Reiter.
Revised 11/21
click to sign
signature
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