Athletic Equipment Manager’s Association
Continuing Education Report Form
Member Information
Last Name: ___________________________ First Name: _______________________________ Middle Init.:_____________
Organization or School:______________________________________________________________________________________
Address: __________________________________________________________________________________________________
City: ________________________ State or Province: _______________ Country: _______________ Postal Code:____________
Area Code and Phone number: ____________________________ Alternate Phone number:_____________________________
Email: _____________________________________________ Member Signature: ______________________________________
Contact/Organization Information (For organization you worked with for ceu’s)
Last Name: ___________________________ First Name: _______________________________ Middle Init.:_____________
Organization or School:______________________________________________________________________________________
Address: __________________________________________________________________________________________________
City: ________________________ State or Province: _______________ Country: _______________ Postal Code:____________
Area Code and Phone number: ____________________________ Alternate Phone number:_____________________________
Email: _____________________________________________
Date of Activity________________________
Contact Hours _____________________
(excludes breaks, meals and non-professional hours)
Please check the category below and verify that all additional information is included.
Activity type
A
B
C
D
AEMA Activities
AEMA approved
meetings.
Publications,
Newsletters,
Interviews
Teaching a class,
Guest Lecturer, and
presentations
X
Category
District Meetings
Must be pre-approved by the CEC Chair
Additional information needed
AEMA Journal
______Answer sheet attached.
National/Olympic
Team work
.
Must be pre-approved by the CEC Chair
______Copy of acceptance letter attached
______Report of work provided included.
Conference meetings and conference calls.
_____Agenda attached
Governing Body Meeting.
______ Itinerary and registration
verification attached
______Agenda included
Other
meetings.
Must be pre-approved by the CEC Chair
______Agenda or summary included.
Publication of original work in a state,
regional or national journal.
___________Copy of paper included.
___________Date published.
Publication of an article related to equipment
management in a newsletter, newspaper or
other similar publication.
Being interviewed for an article/media
production about athletic equipment.
___________Copy
of paper
included.
_______________Where
published
___________Date published.
_______Length of interview.
_______________Where published
Teaching an equipment management course
or a related college course.
_______Credit hours of actual teaching.
Presentation on Athletic Equipment
Management to non-related organizations and
outside group.
______Course syllabus attached.
_______ written summary or outline of the
presentation included.
_______Copy of the article or media
production attached.
Athletic Equipment Manager’s Association
Continuing Education Report Form
Guest Lecturer in a health/physical
education/recreation or other academic class.
_______Outline or summary of
presentation attached.
Presentation at state, district, or national
meetings.
______ Copy of the presentation outline
Repeating a presentation of a previously
given original presentation.
Assisting other organizations with fitting of
athletic equipment.
E
Student Supervision
F
College
Courses/Continuing
Education
Course/Seminars
G
Trainings,
Certifications, Blood
Borne Pathogens
Student Supervision: (Inclusive of high school
managers and pro team managers).
______List of Students Attached
_____Number of credit hours
_____Copy of transcripts and course
description and course syllabus attached.
College Courses
Seminars and other continuing education
activities
________Agenda and a summary of what
was learned attached.
Touring Athletic and Equipment Facilities
________Written summary or outline of
the tour attached.
Educational and Manufacturer Tours
______Itinerary with times listed for
educational tours and talks and a written
summary of the tour attached.
CPR and First Aid
______Copy of the card attached.
Other certifications
I
J
Sporting Goods
Shows and Vendor
Meetings
Special Projects and
Considerations
Sporting Good Shows
_____Vendor List Attached
_____ receipt or nametag attached
Vendor Meetings
________An agenda or a summary of
information is attached
Films, radio conferences, television programs
or other av aids that used as a teaching aid or
for public relations.
_____Summary of the project including a
copy of program attached.
Preparation and presentation of athletic
equipment exhibits at local, district, or national
level.
_____ Verification of participation
attached.
Membership and participation in AEMA
Continuing Education Committee approved
outside organizations.
______Copy of membership invoice or
proof of membership attached.
Acting as equipment manager or host for All
Star games, Olympics and World Championship.
Original Essay
______Proof of Participation or letter of
acceptance attached.
Other activities may be submitted for
consideration.
______Documentation attached.
CEC WORK AREA, PLEASE DO NOT WRITE IN AREA BELOW
CEU Category
CEU’s AWARDED
DATE
DISTC MEMBER’S INITIALS
______Copy of Certification Document
______ Copy of Essay attached.
Notes: