Ethics Module Verification Statement

Verification Statement

After fulfilling the Ethics Module requirement, complete and sign the Verification Statement below. Retain a copy of this signed statement to submit along with your CEPs at the end of your first three-year reporting period.

Name*
First Last
Email*
*
- I have completed the online ethics course for the ATA Certification Program’s Continuing Education requirement.
Date*
MM slash DD slash YYYY
Signature
Consent*
I am voluntarily providing my personal information to ATA and I consent to having such information transferred to, processed, and stored in the United States. I agree to the privacy policy.