CESA Complaint Form
This document is to be used to submit complaints related to APA-approved sponsors
only
.
First Name:
M. I.
Last Name:
Your contact information will be kept confidential.
Email address:
*
Primary Phone:
Country Code:
Alternate Phone:
Country Code:
Name of approved sponsor:
(See the list of
currently approved sponsors
.)
*
Title of program:
*
Date and time offered:
*
Is this a homestudy program?
(Homestudy is defined as any program where there is no ability for live interaction with the presenter.)
*
Yes
No
Did you attend this program?
*
Yes
No
If you answered no, please explain:
Characters remaining:
1000
Have you attempted to resolve this issue with the organization listed above?
Yes
No
Standard(s) related to violation:
Standard A: Goals
Standard B: Program Management
Standard C: Educational Planning and Instructional Methods
Standard D: Curriculum Content
Standard E: Program Evaluation
Standard F: Standards for Awarding Credit
Standard G: Promotion and Advertising of Programs
Description of complaint:
*
Characters remaining:
1000