"Approval of Cdre Activity: Teaching Credit - Application" - Kansas

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Approval of CDRE Activity:
Teaching Credit – Instructions
1.
This form should be submitted by individuals seeking Continuing Dispute Resolution
Education (CDRE) credit for teaching an approved CDRE activity or an approved
primary training course pursuant to Supreme Court Rules 916(d)(3) and 917(b).
2.
CDRE credit granted will be allocated to the compliance period in which the approved
activity or course is taught.
3.
Submit one application for each approved activity or course taught.
4.
Credit will only be granted for preparing and teaching written materials for an approved
CDRE activity.
5.
Make sure the application is accurate. This form will serve as the affidavit of
participation. The Office of Judicial Administration will enter the approved hours
directly into your file based on this information unless modifications are required. Credit
will not be entered into your file unless your name and dispute resolution provider
number are printed clearly and your signature is included at the end of the application.
6.
Notice of approval will be emailed to the individual.
7.
Completed applications (and any attachments) should be submitted to the Director of
Dispute Resolution via mail or email to:
Office of Judicial Administration
th
301 SW 10
Avenue
Topeka, KS 66612-1507
adr@kscourts.org
Required Attachments:
 A written request outlining program content, teaching methodology, and time spent in
preparation and instruction.
INCOMPLETE APPLICATIONS WILL BE RETURNED WITHOUT REVIEW
 
Approval of CDRE Activity:
Teaching Credit – Instructions
1.
This form should be submitted by individuals seeking Continuing Dispute Resolution
Education (CDRE) credit for teaching an approved CDRE activity or an approved
primary training course pursuant to Supreme Court Rules 916(d)(3) and 917(b).
2.
CDRE credit granted will be allocated to the compliance period in which the approved
activity or course is taught.
3.
Submit one application for each approved activity or course taught.
4.
Credit will only be granted for preparing and teaching written materials for an approved
CDRE activity.
5.
Make sure the application is accurate. This form will serve as the affidavit of
participation. The Office of Judicial Administration will enter the approved hours
directly into your file based on this information unless modifications are required. Credit
will not be entered into your file unless your name and dispute resolution provider
number are printed clearly and your signature is included at the end of the application.
6.
Notice of approval will be emailed to the individual.
7.
Completed applications (and any attachments) should be submitted to the Director of
Dispute Resolution via mail or email to:
Office of Judicial Administration
th
301 SW 10
Avenue
Topeka, KS 66612-1507
adr@kscourts.org
Required Attachments:
 A written request outlining program content, teaching methodology, and time spent in
preparation and instruction.
INCOMPLETE APPLICATIONS WILL BE RETURNED WITHOUT REVIEW
Approval of CDRE Activity:
Teaching Credit – Application
Part A: Individual Information (Required on all applications)
Name:
DRP#:
Address:
City, State, Zip:
Phone:
Email (Required):
Part B: Teaching Information (Required on all applications)
Title of Activity:
Approved Program Activity Sponsor:
Title of CDRE Activity:
Approved CDRE Sponsor:
Date(s) of Activity:
Location of Activity:
Audience this activity is directed and advertised to. List all groups invited:
1.
2.
3.
Hours Calculation
Total minutes of instruction:
Divided by 50 minutes equals:
CDRE Hours
Total minutes devoted to:
Domestic Violence Topics:
Ethics:
1
Part C: Verification
I certify that this information is true and complete. I have calculated my hours in Part B based on my actual
teaching time in presentations or courses qualifying me for CDRE credit pursuant to Supreme Court Rule
916(d)(3). Based on this information, the Office of Judicial Administration will enter the approved hours
directly into my record unless a modification is required.
Name (Print)
Signature
Date
2
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