California Escrow Association
The California Escrow Association has developed the attached
documentation package in an effort to bring uniformity to the Escrow I,
Escrow II and Escrow III courses presented by entities other than a
university, college or community college to comply with the California
Escrow Association’s Education Achievement Award and professional
designation requirements.
California Escrow Association
2520 Venture Oaks Way, Suite 150 Sacramento, CA 95833
Tel: (916) 239-4075 Fax: (916) 924-7323 www.ceaescrow.org
Class Presentation Schedule
California Escrow Association 2520 Venture Oaks Way, Suite 150 Sacramento, CA 95833 (916) 239-4075 www.ceaescrow.org Instructions:
Type or print clearly. USE A SEPARATE SHEET OF PAPER FOR EACH CLASS PRESENTATION.
To inform CEA of a new class, mark NEW box and provide all pertinent information below.
To notify CEA of a change to a class schedule previously submitted, mark CHANGE, give the original date, time, and location and provide new information below.
To cancel a class previously submitted, mark CANCEL and complete information below.
This completed form must be received by CEA at least 14 days prior to the original class presentation.
Subsequent presentations must be received at least 10 days prior to class presentation.
Late submissions may not be accepted and attendees may not receive education credit.
The information provided below must match the information on the Certificate of Completion and the provider roster.
CHECK ONE: New Cancel Change Original Date/Time: ___________________
Original Location: ____________________
Provider ED #: ______________________________________
Provider Name: _______________________________________________________________________________ Course ID#: ____________ Credit Hours: ____________ Instructor Name: _____________________ Course Name: _________________________________________________________________________________ Start Date*: ____________ Start Time: ________ End Date: ____________ End Time:________
*if course spans more than one day, each day must be listed in Daily Presentation Schedule chart below.
Location of Presentation: _____________________________________________ (Please name)
Street: __________________________________________________ Room/Suite:_________________ City: ___________________________________________________ State: _________ Zip: ________________ Daily Presentation Schedule:
Day Date: (month/day/year)
Begin Time End Time
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
(Attach sheet for additional days)
I certify that the class information provided here is true and correct to the best of my knowledge. Any changes will be provided to CEA within seven (7) days of provider’s knowledge of the change or within seven (7) days of completion of the class, whichever is earlier.
_____________________________________________________________________________________________ Original Signature of Provider Director Date
_______________________________________________________________________________________________________ Printed Name of Provider Director Phone Number
Continuing Education Program
Course Approval Application for Escrow I, Escrow II and Escrow III
California Escrow Association 2520 Venture Oaks Way, Suite 150 Sacramento, CA 95833 (916) 239-4075 www.ceaescrow.org
Instructions:
This form must be completed for each course to be approved.
A completed application with the proper attachments and filing fee must be received by CEA at least 60 days prior to the first course presentation.
All Courses must be a minimum of 18 hours, no fractional hours are granted.
First Course Presentation Date: __________________________________
Provider Name: _______________________________________________________________________________ Address: _____________________________________________________________________________________ Course Title: *_________________________________________________________________________________ Instruction Method:
Seminar Workshop Other
Classroom/lecture Webinar
Number of continuing education course credit hours requested: __________________________________________
For CEA use only:
_____ Course approved _____ Course not approved
_____________________________________________________________________________________________ _____________________________________________________________________________________________ By: _________________________________________________________________________________________ Name: Date
Title:
*Advertising and course materials must use this exact title. Courses based on another provider’s material must be approved by that provider and must use same name.
REQUIRED ATTACHMENT CHECKLIST:
1. _____ A detailed outline of each topic is being presented, i.e.: class syllabus and final
exam
2. _____ A copy of all materials presented to each student – must comply with minimum
requirements as outlined in the Escrow I, Escrow II and Escrow III manuals
approved by CEA.
3. _____ Educational objectives for the course.
CERTIFICATION: I certify under penalty of perjury that I have read and understand the
information and requirements contained in this application, that all statements are true and
nothing has been withheld which would influence a complete evaluation of this course.
______________________________________________________________________________
Original Signature of Provider Director Date
______________________________________________________________________________
Printed Name of Provider Director
PLEASE SEND THIS COMPLETED APPLICATION ALONG WITH THE PROPER
ATTACHMENTS AND FILING FEE TO:
California Escrow Association Filing Fees:
2520 Venture Oaks Way, Suite 150 Make check payable to: CEA
Sacramento, CA 95833
Tel: (916) 239-4075
Fax: (916) 924-7323
www.ceaescrow.org
Course applications must be received in this office at least 60 days prior to the first course
presentation date. No education credit will be granted prior to the 60
thday from receipt of the
completed application. Course advertisements for pending courses must clearly state that the
course has been submitted and is pending approval, if the course application is complete and
submitted within the appropriate time frame. INQUIRIES: (916) 239-4075
Continuing Education Program
Course Attendance Record and Verification Form
California Escrow Association 2520 Venture Oaks Way, Suite 150 Sacramento, CA 95833 (916) 239-4075 www.ceaescrow.org
Course Title: __________________________________________________________________
Provider Name: ________________________________________________________________
Class Location: ________________________________________________________________
Street City State
Class Date(s): _______________________________________________________________________________
VERIFICATION:
I have reviewed and verified that the persons named on the attached Course Attendance Record
Sheet(s), consisting of _______ pages, were present at this class during the times and days
indicated.
______________________________________________________________________________
Original Signature of Instructor Date
______________________________________________________________________________
Printed Name of Instructor
CERTIFICATION:
I have reviewed and verified this Course Attendance Record Verification and the attached
Course Attendance Record Sheet(s), and certify that I find them accurate and in order, to the best
of my knowledge.
______________________________________________________________________________
Original Signature of Provider Director Date
______________________________________________________________________________
Printed Name of Provider Director
Continuing Education Program
Instructor Qualification Form
California Escrow Association 2520 Venture Oaks Way, Suite 150 Sacramento, CA 95833 (916) 239-4075 www.ceaescrow.org Instructions:
This form must be completed by each proposed instructor, lecturer, moderator or person conducting a classroom course, seminar, workshop, conference, etc.
Type or print clearly in ink.
Provider Director must verify the information provided by the instructor.
Attach additional sheets if more space is needed to answer questions.
Date: ____________________________
Provider Name: _______________________________________________________________________________ Address: ____________________________________________________________________________________ Telephone Number: ____________________________________________________________________________ E-Mail: ______________________________________________________________________________________ Instructor Name: ______________________________________________________________________________ Mailing Address: ______________________________________________________________________________ Telephone Number: ____________________________________________________________________________ E-Mail: ______________________________________________________________________________________ List the course titles to be taught:
_____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Describe your experience (3 years within the last 5 years) in the course subject matter:
_____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________
Please indicate if you hold a recognized professional designation from the California Escrow Association: __ Yes __ No If yes, check all that apply
CEI _____ CBSS _____ CMHS _____ CSEO _____ CEO _____ Other: _______________
Have you ever been the subject of any administrative agency disciplinary action? For the purpose of this question, administrative agency disciplinary action includes but is not limited to: having any professional, vocational or business license denied, suspended, placed on probation, restricted or revoked, or any fine imposed; withdrawing any application or surrendering any license to avoid disciplinary action; being issued a cease and desist order or its equivalent; being the subject of a conservation, liquidation, rehabilitation or receivership order.
_____ Yes _____ No
Have you ever been convicted of a crime? _____ Yes _____ No
“Crime” includes a felony or misdemeanor and military offenses. “Convicted” includes, but is not limited to, having been found guilty by verdict of a judge or jury, having entered a please of guilty or nolo contendere, having had any charge dismissed, expunged or plea withdrawn pursuant to Penal Code Section 1203.4, or having been given probation, a suspended sentence or a fine. You may exclude traffic citations and juvenile offenses.
IMPORTANT NOTE: If the answer is “YES” to either of the above two questions, attach a detailed statement, signed by you, listing the events which led to the charges (dates and places). If any disciplinary action was taken by an administrative agency, attach a certified copy of the action.
INSTRUCTOR CERTIFICATION
I certify under penalty of perjury that the information contained in this application is true and correct and that nothing has been withheld which would influence a complete evaluation of my qualifications and conduct as an instructor.
_____________________________________________________________________________________________
Original Signature of Instructor Date
PROVIDER VERIFICATION
I certify under penalty of perjury that I have reviewed and verified the qualifications of the instructor named above.
_____________________________________________________________________________________________ Original Signature of Provider Director Date
_____________________________________________________________________________________________ Printed Name of Provider Director
CEA – Industry: Provider, Course and Instructor Requirements
Escrow I, Escrow II and Escrow III
Provider Requirements
1) In order to apply for CEA Approved Education Provider Status, please Complete Form _____, Provider Certification Application and submit to the CEA Education Committee via CEA Headquarters. Application fee is $100.00 payable to CEA. Approvals are good for two (2) years from the date of approval by the CEA Education Committee.
2) Providers are required to maintain, for a period of three (3) years, records of enrollments, completions, attendance, examination grades and instructor qualifications. These records shall be made available to CEA as requested.
3) Sign-in and sign-out sheets are required for each session.
4) Providers shall provide Certificates of Completion to those students successfully completing a course. Said Certificate of Completion to state hours attended and final grade.
5) Within 30 days following class completion, providers shall submit to CEA a provider Roster listing students given Certificates of Completion.
6) Course Applications can be submitted at the same time as Provider Applications. Course Requirements for Escrow I, Escrow II or Escrow III:
1) An approved provider must complete and submit Form ______, Course Approval Application, to CEA Education Committee for approval of each course to be offered. Application fees are $50.00 for each course. Approvals are good for two (2) years from date of approval.
2) Credit hours will be determined using a 50 minute contract hour.
3) Applications must include a detailed outline of the subject to be covered, examinations to be given, and scheduled times for starting and ending.
4) Applications must include the Instructor Qualification Form _____.
5) Applications must be received by CEA at least 60 days before course beginning date. 6) No student shall receive instruction for more than eight (8) hours per day.
Instructor Requirements
1) Hold a professional designation from CEA of Certified Escrow Instructor. OR
2) Possess scholastic credentials, including, but not limited to, a current teaching credential from any state.
Disclaimer – No course approved shall be construed to be advertised or promoted as endorsed by the California Escrow Association.
Continuing Education Program
Provider Certification/Renewal Application
California Escrow Association 2520 Venture Oaks Way, Suite 150 Sacramento, CA 95833 (916) 239-4075 www.ceaescrow.org 1. Check one only: Original filing Renewal Change of Provider Director
Provider #____________________
2. Entity Name:
_________________________________________________________________________________________ 3. Business Address:
_____________________________________________________________________________________ 4. Mailing Address:
_____________________________________________________________________________________ 5. Website: ____________________________________________________________________
PROVIDER DIRECTOR: Individual within a provider organization with responsibility for the administration of the programs approved by CEA.
6 Provider Director Name:
_______________________________________________________________________________
Last First Middle
7 Mailing Address:
_____________________________________________________________________________________ 8. Phone Numbers:
______________________________________________________________________________________
Business Facsimile
9. E-mail address:
_______________________________________________________________________________________
10. Is this organization now using or has it ever used any name other than #2 listed above? _____ Yes _____ No
If YES, list such names and dates used: __________________________________________________
___________________________________________________________________________________ 11. The following information is required:
a. Sample of attendance records form proposed for use meeting the requirement of CEA. b. Sample Certificate of Completion.
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CERTIFICATION
I agree to (a) maintain records of enrollments, attendance, exam grades and other pertinent information as requested by the California Escrow Association for a period of three years (b) provide certificates of completion to those students who successfully complete courses (c) use only qualified instructors to conduct courses (d) timely provide CEA with completed course approval applications for programs submitted for credit approval, and (e) comply with CEA’s continuing education regulations. Further, I certify under penalty of perjury that I am the person who has responsibility for the administration of the operations contained in this application; that the information contained in this application is true and correct; and that no approved course will be offered for credit unless the organization holds an active provider approval status. Lastly, I understand that I must promptly report to CEA any changes in the information contained in this form.
__________________________________________________________________________________________________________________
Original Signature of Provider Director Date
__________________________________________________________________ Print Name
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Filing Instructions:
This form must be completed by each entity desiring to be certified or to renew certification as a
continuing education provider.
Type or print clearly in ink. All sections of this form must be completed and submitted with
proper attachments and filing fees to CEA.
Attach additional sheets if more space is needed to answer questions.
Please send this completed application, other required attachments and a non-refundable $100.00
filing fee to:
Make checks California Escrow Association
payable to: 2520 Venture Oaks Way, Suite 150
Sacramento, CA 95833
Tel: (916) 239-4075 Fax: (916) 924-7323 www.ceaescrow.org
