SS&C Learning Institute – CPE Credit Application and Evaluation Form

Instructions 1. Complete this application and evaluation form (2 pages) 2. E-mail this document as an attachment to [email protected]

Please allow 5-10 business days for your application to be processed

Name: Company: Address: E-mail: Professional status (please place CPA MBA CPCU an X in the box to the right of the appropriate designation):

Other (explain): State where applicant is licensed: Course(s) completed (please list):

I certify that I personally completed the course for which credit is requested and that I achieved a score of 70% or higher.

Name: ______Date: ______Please indicate your level of agreement by marking the appropriate box with an X.

Strongly Neutral Strongly Agree Disagree 5 4 3 2 1

The stated learning objectives of the course were met. The program content was timely and relevant. The program content was accurate. The prerequisite requirements of the course were appropriate. Advance materials (such as the pre-test) were satisfactory. The estimated time stated at the beginning of the course was appropriate. Technology was used appropriately and satisfactorily. Animations, slide shows, and other media were effective. The concepts were presented in a clear and easily understandable way. The concepts presented will be applicable to my current or expected position. Course material was valuable, I acquired new knowledge or improved skills. I would recommend this product to a colleague.

Excellent Neutral Poor 5 4 3 2 1

Overall, how would you rate the quality of your training experience?

How many hours did it take you to complete the course and test(s)?

As we build the Zoologic library, we would like to meet your needs and interests. Which of the topic areas below are of interest to you? (Mark with an X.)

Cash Management Structured Finance Personal Finance Commodities Insurance Asset/Liability Management

Other (please list):

Would you be interested in training with any of the other Zoologic titles? Yes No

What else would you like us to know?