HealthStream and CE Unlimited Request Form

Welcome to the SEIU Healthcare 1199NW Multi-Employer Training and Education Fund!

Please submit this form to apply for free access to our new CEU provider, HealthStream with CE Unlimited - where you can learn and earn CEU's that apply to your certifications and/or licensure maintenance. It's a full service provider of CEU's with thousands of approved CE courses and the ability to track your certifications, licenses, and education!

Please read below on our disclaimer regarding third-party services:

The Training Fund contracts with vendors for provision of certain services. Based on Trainings Fund’s contract with each vendor, the Training Fund has agreed that members accessing the service will comply with the policies and terms provided directly by the vendor. By utilizing vendor services though the Training Fund, members agree to these terms. If the vendor discontinues provision of service due to any reason for a member, Training Fund will work with member to explore alternatives that maybe available within current benefits, programs and services.

NOTE: PER DIEM & CONTRACT EMPLOYEES ARE NOT ELIGIBLE FOR THIS SERVICE

Complete this form for access to online Continuing Education (CE) courses. Please enter the full first and last name your employer has on file.

First Name

Middle Initial

Last Name

Home Address

Home City

Home State

Home Zip/Postal

Preferred Phone Number

Phone

May we text you at this number?

Preferred Email

User ID for HealthStream - HealthStream STRONGLY recommends that your User ID for their platform be your PERSONAL email. This will help if you ever change employers and no longer have access to a work email. While you are able to update your email for communications, we CANNOT change your user ID once we enter it into their system. Please provide a personal email address for your User ID.

Please tell us how you intend to use HealthStream and the CE Unlimited Benefit:

Employer

Worksite Location/Campus (SMC First Hill, Lidgerwood KP, VMC Kent Clinic, Main, etc.)

Department

Worksite Location

Job Title

Bargaining Unit

Current FTE

Date of Hire (mm/dd/yyyy format)

Lead Source

Record Type

Opportunity Stage

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• https://healthcareerfund.org/wp-content/uploads/2018/08/Final-confidentiality-statement.pdf

• Please Note that in completing the attached "Application," you are also agreeing to the following statement:

I have had the opportunity to read and review the SEIU Healthcare 1199NW Training Fund Privacy Policy. By filling out and submitting this Application/Intake Form, I agree to this Privacy Policy and authorize the Training Fund to contact, or my behalf, current or previous employers or educational institutions, or other relevant entities, to obtain information that may be necessary for the administration of the Training Fund's benefits. I further understand this authorization is on-going for the purposes of administering the Training Fund's benefits.

I agree

DATA SHARING WITH LABOR MANAGEMENT PARTNERS

The SEIU Healthcare 1199NW Training Fund provides specific details about active members' usage of Training Fund programs and services to both employer and labor partners. Sharing this information allows labor/management partners to do more targeted workforce planning, and also support individuals in their career and programmatic path. Data that we share does not include Date of Birth and Social Security Number.

Do you agree to allow the Training Fund to share your information with employer partners:

Do you agree to allow the Training Fund to share your information with SEIU Healthcare 1199NW:

TEXT MESSAGING POLICY

Your education and career advancement and training opportunities are important to us. In order to provide you with the up-to-date-service, we occasionally send text messages to our members about their education and training benefits and services. Standard text messaging rates apply.

By completing this form, you authorize text messaging from Fund unless you decline text messaging. To decline Text Messages, email your Regional Education Navigator or members@healthcareerfund.org stating that you do not want to receive text messages.

You can decline text messages at any time. Under some circumstances this may delay your receiving information on your program(s). Please talk with your Navigator (if you don’t have one, one will be assigned on submittal of this form) if you have questions on text messaging.

PHOTO/VIDEO USE POLICY – TRAINING FUND EVENTS

The ability to communicate about Training Fund services to our members and to use information gathered in classes and sessions for further training is important to the Training Fund.

Unless you decline photo/video by the Fund, by completing this form you authorize and agree that the SEIU Healthcare 1199NW Multi-Employer Training & Education Fund and SEIU Healthcare 1199NW may use photographic images or video footage of you, or in which you are included, taken during Training Fund related classes, sessions, or events, for public relations, program marketing, electronic media, or educational purposes.

To opt out from photo/video use, please send a separate email your Regional Education Navigator or members@healthcareerfund.org stating that you do not want your images/video to be used for Training Fund purposes.

You may opt out of photo/video use at any time. Please talk with your Navigator (if you don’t have one, one will be assigned on submittal of this form) if you have questions on photo/video use.

NON-DISCRIMINATION POLICY STATEMENT

The Training Fund is dedicated to equal opportunity education and training. It does not discriminate on the basis of race, creed, color, ethnicity, national origin, religion, sex, sexual orientation, gender expression, age, physical or mental ability, veteran status, military obligations, background, or marital status.

Contact Information