• To keep track of your Category B CEPs, complete the form below. You must print and keep a copy of this form for your records. ATA does not receive or keep a copy. You may be asked to provide a copy of this form to ATA at the end of your three-year reporting period.
  • Independent Study Verification

  • Enter your ATA membership number if you have one.
  • Enter your ATA Certification Number
  • MM slash DD slash YYYY


  • Please give short answers to the following questions

Share this