Public Consulting Group (PEPPER)

PDU REQUEST FORM

Admissions Notes

Full First & Last Name

Phone

Previous Name(s) if any:

Last 4 digits (SSN)

Date of Birth

Home Address

Mailing Address

Name of College/University

You must submit a CERTIFICATE OF COMPLETION to receive units. Transcripts will not be accepted.

Upload Certificate of Completion (Transcripts NOT Acceptable)

Upload Certificate of Completion (if applicable)

I understand that an official transcript is not included with this purchase.

I understand that I need to check with my employer to ensure they will accept PDUs.

I certify that the information given in this request form is complete and accurate.

Your Signature

Select the course you completed:

6015-CDEM1-7 PEPPER Building a Strong Foundation: Developing Early Literacy Skills (3 PDUs) - $225

6015 PEPPER - 1 Professional Development Unit - $75

6015 PEPPER - 2 Professional Development Units - $150

6015 PEPPER - 3 Professional Development Units - $225

1037 PEPPER: Building a Strong Foundation for Lifelong Literacy Success (3 PDU's) - $225