{"id":71,"date":"2020-12-13T18:29:04","date_gmt":"2020-12-13T18:29:04","guid":{"rendered":"https:\/\/schultzwebdesign.se\/EMT\/?page_id=71"},"modified":"2020-12-13T18:29:04","modified_gmt":"2020-12-13T18:29:04","slug":"ceu-request","status":"publish","type":"page","link":"https:\/\/schultzwebdesign.se\/EMT\/ceu-request\/","title":{"rendered":"CEU Request"},"content":{"rendered":"<div data-role=\"page-header\" data-has-realtime-calculations=\"\">\n<div id=\"form-heading-00000002-acc\" data-role=\"control\" data-type=\"form-header\" data-hash=\"00000002\" data-type-id=\"27\" data-colspan=\"20\" aria-labelledby=\"form-heading-00000002-acc\" data-i18n-html=\"Headline\">\n<h1>CEU Request<br \/>\nThank you for taking your course with us! We are happy to issue CEU for qualifying students. Please fill out the form below to submit your application. If you have any questions please call us at 541-844-1328 or e-mail <a href=\"mailto:emt.associates@comcast.net\" rel=\"nofollow ugc\">emt.associates@comcast.net<\/a>.<br \/>\n<em>Please note, we do not issue CEU for ENA courses.<br \/>\n<\/em><em>You will receieve your CEU via e-mail once your request has been processed.\u00a0<\/em><\/h1>\n<\/div>\n<\/div>\n<div data-role=\"page-body\">\n<div data-role=\"container\" data-type=\"virtual-form-table-row\" data-hash=\"00000007\" data-type-id=\"0\" data-colspan=\"20\" data-num-children=\"1\">\n<div data-role=\"control\" data-type=\"name\" data-hash=\"00000008\" data-type-id=\"12\" data-colspan=\"20\" aria-labelledby=\"name-00000008-acc name-00000008-error-acc name-00000008-instr-acc\" data-is-required=\"1\" data-renderer-type=\"lln\" data-label-width=\"5\" data-id=\"28227772\">\n<div data-role=\"label-column\" data-colspan=\"5\"><label id=\"name-00000008-acc\" data-role=\"label\" data-i18n-text=\"control_label_28227772\">Name<\/label><\/div>\n<div data-role=\"input-column\" data-colspan=\"15\">\n<div data-role=\"input-row\" data-is-first-row=\"1\" data-is-last-row=\"1\" data-fill-colspan=\"8\"><input class=\"\" type=\"text\" placeholder=\"First\" data-role=\"i123-input\" data-index=\"1\" data-i18n-placeholder=\"textdef_30\" data-size=\"fill\" \/><input type=\"text\" placeholder=\"Last\" data-role=\"i123-input\" data-index=\"2\" data-i18n-placeholder=\"textdef_31\" data-size=\"half\" \/><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div data-role=\"container\" data-type=\"virtual-form-table-row\" data-hash=\"00000009\" data-type-id=\"0\" data-colspan=\"20\" data-num-children=\"1\">\n<div data-role=\"control\" data-type=\"address\" data-hash=\"0000000a\" data-type-id=\"1\" data-colspan=\"20\" aria-labelledby=\"address-0000000a-acc address-0000000a-error-acc address-0000000a-instr-acc\" data-renderer-type=\"lln\" data-label-width=\"5\" data-id=\"28443699\">\n<div data-role=\"label-column\" data-colspan=\"5\"><label id=\"address-0000000a-acc\" data-role=\"label\" data-i18n-text=\"control_label_28443699\">Address<\/label><\/div>\n<div data-role=\"input-column\" data-colspan=\"15\">\n<div data-role=\"input-row\" data-is-first-row=\"1\" data-fill-colspan=\"0\"><input type=\"text\" placeholder=\"Street Address\" data-role=\"i123-input\" data-index=\"1\" data-i18n-placeholder=\"textdef_24\" data-size=\"full\" \/><\/div>\n<div data-role=\"input-row\" data-fill-colspan=\"0\"><input type=\"text\" placeholder=\"Street Address Line 2\" data-role=\"i123-input\" data-index=\"2\" data-i18n-placeholder=\"textdef_25\" data-size=\"full\" \/><\/div>\n<div data-role=\"input-row\" data-fill-colspan=\"8\"><input type=\"text\" placeholder=\"City\" data-role=\"i123-input\" data-index=\"3\" data-i18n-placeholder=\"textdef_26\" data-size=\"half\" \/><input type=\"text\" placeholder=\"Region\" data-role=\"i123-input\" data-index=\"4\" data-i18n-placeholder=\"textdef_27\" data-size=\"fill\" \/><\/div>\n<div data-role=\"input-row\" data-is-last-row=\"1\" data-fill-colspan=\"8\"><input type=\"text\" placeholder=\"Postal \/ Zip Code\" data-role=\"i123-input\" data-index=\"5\" data-i18n-placeholder=\"textdef_28\" data-size=\"half\" \/><\/p>\n<div tabindex=\"0\" data-ui-role=\"ui-element\" data-type=\"searchable-dropdown\" data-role=\"i123-input\" data-index=\"6\" data-size=\"fill\"><input autocomplete=\"none\" type=\"text\" placeholder=\"Country\" data-i18n-placeholder=\"textdef_29\" \/><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div data-role=\"page-body\">\n<div data-role=\"container\" data-type=\"virtual-form-table-row\" data-hash=\"00000009\" data-type-id=\"0\" data-colspan=\"20\" data-num-children=\"1\">\n<div data-role=\"control\" data-type=\"address\" data-hash=\"0000000a\" data-type-id=\"1\" data-colspan=\"20\" aria-labelledby=\"address-0000000a-acc address-0000000a-error-acc address-0000000a-instr-acc\" data-renderer-type=\"lln\" data-label-width=\"5\" data-id=\"28443699\">\n<div data-role=\"input-column\" data-colspan=\"15\"><\/div>\n<\/div>\n<\/div>\n<div data-role=\"container\" data-type=\"virtual-form-table-row\" data-hash=\"0000000b\" data-type-id=\"0\" data-colspan=\"20\" data-num-children=\"1\">\n<div data-role=\"control\" data-type=\"phone\" data-hash=\"0000000c\" data-type-id=\"16\" data-colspan=\"20\" data-is-required=\"1\" data-renderer-type=\"lln\" data-label-width=\"5\" data-id=\"28227773\">\n<div data-role=\"label-column\" data-colspan=\"5\"><label id=\"phone-0000000c-acc\" data-role=\"label\" data-i18n-text=\"control_label_28227773\">Phone<\/label><\/div>\n<div data-role=\"input-column\" data-colspan=\"15\">\n<div data-role=\"input-row\" data-is-first-row=\"1\" data-is-last-row=\"1\" data-fill-colspan=\"0\"><input type=\"text\" placeholder=\"### ### #### \" data-role=\"i123-input\" aria-labelledby=\"phone-0000000c-acc phone-0000000c-format-acc phone-0000000c-error-acc phone-0000000c-instr-acc\" data-size=\"full\" \/><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div data-role=\"container\" data-type=\"virtual-form-table-row\" data-hash=\"0000000d\" data-type-id=\"0\" data-colspan=\"20\" data-num-children=\"1\">\n<div data-role=\"control\" data-type=\"email\" data-hash=\"0000000e\" data-type-id=\"5\" data-colspan=\"20\" data-is-required=\"1\" data-renderer-type=\"lln\" data-label-width=\"5\" data-id=\"28227781\">\n<div data-role=\"label-column\" data-colspan=\"5\"><label id=\"email0000000e-acc\" data-role=\"label\" data-i18n-text=\"control_label_28227781\">Email<\/label><\/div>\n<div data-role=\"input-column\" data-colspan=\"15\">\n<div data-role=\"input-row\" data-is-first-row=\"1\" data-is-last-row=\"1\" data-fill-colspan=\"0\"><input type=\"email\" data-role=\"i123-input\" aria-labelledby=\"email0000000e-acc email-0000000e-error-acc email-0000000e-instr-acc\" data-size=\"full\" \/><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div data-role=\"container\" data-type=\"virtual-form-table-row\" data-hash=\"0000000f\" data-type-id=\"0\" data-colspan=\"20\" data-num-children=\"1\">\n<div data-role=\"control\" data-type=\"check-box\" data-hash=\"00000010\" data-type-id=\"2\" data-colspan=\"20\" aria-labelledby=\"checkbox-00000010-acc checkbox-00000010-error-acc checkbox-00000010-instr-acc\" data-is-required=\"1\" data-renderer-type=\"lln\" data-label-width=\"5\" data-id=\"28227745\">\n<div data-role=\"label-column\" data-colspan=\"5\"><label id=\"checkbox-00000010-acc\" data-role=\"label\" data-i18n-text=\"control_label_28227745\">CEU Request(s) &#8211; $20 PER COURSE<\/label><\/div>\n<div data-role=\"input-column\" data-colspan=\"15\">\n<div data-role=\"input-row\" data-is-first-row=\"1\" data-fill-colspan=\"0\">\n<div data-role=\"choice\" data-index=\"0\" data-size=\"full\"><label id=\"checkbox-00000010-0\" data-role=\"choice\"><input id=\"00000010_0\" type=\"checkbox\" data-role=\"i123-input\" data-index=\"0\" data-value=\"ACLS Re-Certification (1 Day) - 7 Hours\" \/><label role=\"checkbox\" for=\"00000010_0\" data-role=\"checkbox\" aria-labelledby=\"checkbox-00000010-0\"><\/label><span data-role=\"option-text\" data-i18n-html=\"control_label_28227745_choice_0\" data-skip-markdown=\"true\">ACLS Re-Certification (1 Day) &#8211; 7 Hours<\/span><\/label><\/div>\n<\/div>\n<div data-role=\"input-row\" data-fill-colspan=\"0\">\n<div data-role=\"choice\" data-index=\"1\" data-size=\"full\"><label id=\"checkbox-00000010-1\" data-role=\"choice\"><input id=\"00000010_1\" type=\"checkbox\" data-role=\"i123-input\" data-index=\"1\" data-value=\"ACLS Provider (2 Days) - 12 Hours\" \/><label role=\"checkbox\" for=\"00000010_1\" data-role=\"checkbox\" aria-labelledby=\"checkbox-00000010-1\"><\/label><span data-role=\"option-text\" data-i18n-html=\"control_label_28227745_choice_1\" data-skip-markdown=\"true\">ACLS Provider (2 Days) &#8211; 12 Hours<\/span><\/label><\/div>\n<\/div>\n<div data-role=\"input-row\" data-fill-colspan=\"0\">\n<div data-role=\"choice\" data-index=\"2\" data-size=\"full\"><label id=\"checkbox-00000010-2\" data-role=\"choice\"><input id=\"00000010_2\" type=\"checkbox\" data-role=\"i123-input\" data-index=\"2\" data-value=\"PALS Re-Certification (1 Day) - 7 Hours\" \/><label role=\"checkbox\" for=\"00000010_2\" data-role=\"checkbox\" aria-labelledby=\"checkbox-00000010-2\"><\/label><span data-role=\"option-text\" data-i18n-html=\"control_label_28227745_choice_2\" data-skip-markdown=\"true\">PALS Re-Certification (1 Day) &#8211; 7 Hours<\/span><\/label><\/div>\n<\/div>\n<div data-role=\"input-row\" data-fill-colspan=\"0\">\n<div data-role=\"choice\" data-index=\"3\" data-size=\"full\"><label id=\"checkbox-00000010-3\" data-role=\"choice\"><input id=\"00000010_3\" type=\"checkbox\" data-role=\"i123-input\" data-index=\"3\" data-value=\"PALS Provider (2 Days) - 12 Hours\" \/><label role=\"checkbox\" for=\"00000010_3\" data-role=\"checkbox\" aria-labelledby=\"checkbox-00000010-3\"><\/label><span data-role=\"option-text\" data-i18n-html=\"control_label_28227745_choice_3\" data-skip-markdown=\"true\">PALS Provider (2 Days) &#8211; 12 Hours<\/span><\/label><\/div>\n<\/div>\n<div data-role=\"input-row\" data-is-last-row=\"1\" data-fill-colspan=\"0\">\n<div data-role=\"choice\" data-index=\"4\" data-size=\"full\"><label id=\"checkbox-00000010-4\" data-role=\"choice\"><input id=\"00000010_4\" type=\"checkbox\" data-role=\"i123-input\" data-index=\"4\" data-value=\"PEARS - 6 Hours\" \/><label role=\"checkbox\" for=\"00000010_4\" data-role=\"checkbox\" aria-labelledby=\"checkbox-00000010-4\"><\/label><span data-role=\"option-text\" data-i18n-html=\"control_label_28227745_choice_4\" data-skip-markdown=\"true\">PEARS &#8211; 6 Hours<\/span><\/label><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div data-role=\"container\" data-type=\"virtual-form-table-row\" data-hash=\"00000011\" data-type-id=\"0\" data-colspan=\"20\" data-num-children=\"1\">\n<div data-role=\"control\" data-type=\"text\" data-hash=\"00000012\" data-type-id=\"23\" data-colspan=\"20\" data-is-required=\"1\" data-renderer-type=\"lln\" data-label-width=\"5\" data-id=\"28227782\">\n<div data-role=\"label-column\" data-colspan=\"5\"><label id=\"text-00000012-acc\" data-role=\"label\" data-i18n-text=\"control_label_28227782\">Month\/Year of Course(s)<\/label><\/div>\n<div data-role=\"input-column\" data-colspan=\"15\">\n<div data-role=\"input-row\" data-is-first-row=\"1\" data-is-last-row=\"1\" data-fill-colspan=\"0\">\n<div data-role=\"input-container\" data-ui-role=\"ui-element\" data-size=\"full\"><span id=\"price-00000012-prefix-acc\" data-role=\"prefix-label\"><\/span><input id=\"text-00000012\" type=\"text\" placeholder=\"\" data-role=\"i123-input\" data-no-theme=\"\" aria-labelledby=\"text-00000012-acc text-00000012-error-acc text-00000012-instr-acc\" \/><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div data-role=\"container\" data-type=\"virtual-form-table-row\" data-hash=\"00000013\" data-type-id=\"0\" data-colspan=\"20\" data-num-children=\"1\">\n<div data-role=\"control\" data-type=\"radio\" data-hash=\"00000014\" data-type-id=\"18\" data-colspan=\"20\" aria-labelledby=\"radio-00000014-acc radio-00000014-clearable-button-acc radio-00000014-error-acc radio-00000014-instr-acc\" data-is-required=\"1\" data-renderer-type=\"lln\" data-label-width=\"5\" data-id=\"28443703\">\n<div data-role=\"label-column\" data-colspan=\"5\"><label id=\"radio-00000014-acc\" data-role=\"label\" data-i18n-text=\"control_label_28443703\">How would you like your CEU certificate delivered?<\/label><\/div>\n<div data-role=\"input-column\" data-colspan=\"15\">\n<div data-role=\"input-row\" data-is-first-row=\"1\" data-fill-colspan=\"0\">\n<div data-role=\"choice\" data-size=\"full\"><label id=\"radio-000000140\" data-role=\"choice\"><input id=\"00000014_0\" name=\"c_00000014\" type=\"radio\" value=\"Shipped - $2.50\" data-index=\"0\" data-role=\"i123-input\" \/><label role=\"radio\" for=\"00000014_0\" data-role=\"radio\" aria-labelledby=\"radio-000000140\"><\/label><span data-role=\"option-text\" data-i18n-html=\"control_label_28443703_choice_0\" data-skip-markdown=\"true\">Shipped &#8211; $2.50<\/span><\/label><\/div>\n<\/div>\n<div data-role=\"input-row\" data-fill-colspan=\"0\">\n<div data-role=\"choice\" data-size=\"full\"><label id=\"radio-000000141\" data-role=\"choice\"><input id=\"00000014_1\" name=\"c_00000014\" type=\"radio\" value=\"Scanned and sent via e-mail\" data-index=\"1\" data-role=\"i123-input\" \/><label role=\"radio\" for=\"00000014_1\" data-role=\"radio\" aria-labelledby=\"radio-000000141\"><\/label><span data-role=\"option-text\" data-i18n-html=\"control_label_28443703_choice_1\" data-skip-markdown=\"true\">Scanned and sent via e-mail<\/span><\/label><\/div>\n<\/div>\n<div data-role=\"input-row\" data-is-last-row=\"1\" data-fill-colspan=\"0\">\n<div data-role=\"choice\" data-size=\"full\"><label id=\"radio-000000142\" data-role=\"choice\"><input id=\"00000014_2\" name=\"c_00000014\" type=\"radio\" value=\"I will pick up in the office\" data-index=\"2\" data-role=\"i123-input\" \/><label role=\"radio\" for=\"00000014_2\" data-role=\"radio\" aria-labelledby=\"radio-000000142\"><\/label><span data-role=\"option-text\" data-i18n-html=\"control_label_28443703_choice_2\" data-skip-markdown=\"true\">I will pick up in the office<\/span><\/label><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div data-role=\"container\" data-type=\"virtual-form-table-row\" data-hash=\"00000015\" data-type-id=\"0\" data-colspan=\"20\" data-num-children=\"1\">\n<div data-role=\"control\" data-type=\"text\" data-hash=\"00000016\" data-type-id=\"23\" data-colspan=\"20\" data-is-required=\"1\" data-renderer-type=\"lln\" data-label-width=\"5\" data-id=\"37259405\">\n<div data-role=\"label-column\" data-colspan=\"5\"><label id=\"text-00000016-acc\" data-role=\"label\" data-i18n-text=\"control_label_37259405\">Your License # [needed for certificate]<\/label><\/div>\n<div data-role=\"input-column\" data-colspan=\"15\">\n<div data-role=\"input-row\" data-is-first-row=\"1\" data-is-last-row=\"1\" data-fill-colspan=\"0\">\n<div data-role=\"input-container\" data-ui-role=\"ui-element\" data-size=\"full\"><span id=\"price-00000016-prefix-acc\" data-role=\"prefix-label\"><\/span><input id=\"text-00000016\" type=\"text\" placeholder=\"\" data-role=\"i123-input\" data-no-theme=\"\" aria-labelledby=\"text-00000016-acc text-00000016-error-acc text-00000016-instr-acc\" \/><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div data-role=\"page-footer\">\n<div data-role=\"control\" data-type=\"payments-selector\" data-renderer-type=\"tln\"><label data-role=\"label\" data-i18n-text=\"textdef_60\">Payment Method<\/label><\/p>\n<div data-role=\"nowrap\"><label data-role=\"main\"><input checked=\"checked\" name=\"form-payment-processor\" type=\"radio\" value=\"1\" data-role=\"i123-input\" \/><img decoding=\"async\" src=\"https:\/\/cdn.123formbuilder.com\/images3\/payments-editor-v2\/paypal.png?2\" alt=\"PayPal\" \/><\/label><\/div>\n<div data-role=\"frontend-plugin\"><\/div>\n<\/div>\n<div data-role=\"control\" data-type=\"form-action-bar\" data-hash=\"00000003\" data-type-id=\"29\" data-colspan=\"20\" data-buttons-position=\"0\"><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>CEU Request Thank you for taking your course with us! We are happy to issue CEU for qualifying students. Please [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/schultzwebdesign.se\/EMT\/wp-json\/wp\/v2\/pages\/71"}],"collection":[{"href":"https:\/\/schultzwebdesign.se\/EMT\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/schultzwebdesign.se\/EMT\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/schultzwebdesign.se\/EMT\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/schultzwebdesign.se\/EMT\/wp-json\/wp\/v2\/comments?post=71"}],"version-history":[{"count":1,"href":"https:\/\/schultzwebdesign.se\/EMT\/wp-json\/wp\/v2\/pages\/71\/revisions"}],"predecessor-version":[{"id":72,"href":"https:\/\/schultzwebdesign.se\/EMT\/wp-json\/wp\/v2\/pages\/71\/revisions\/72"}],"wp:attachment":[{"href":"https:\/\/schultzwebdesign.se\/EMT\/wp-json\/wp\/v2\/media?parent=71"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}