PACE

College Code	(only needed for Chiropractic Colleges)	This application is required to initiate the formal application for PACE status, which includes establishing necessary electronic and Internet accounts. HINTS User names are often formed by combining your first initial with your last name (GWashington for George Washington). Be more creative for common last names like Smith (AJSmith). Names and passwords are NOT case sensitive - AJSmith is the same as ajsmith.
	All fields below are required
Provider:
Mailing Address1:
Mailing Address2:
City:
State:
Zip:
Website:
	Primary Contact
Primary Contact:
First Name:
Last Name:
Title:
Phone:
Email:
User Name:
Password:
	Secondary Contact

First Name:
Last Name:
Title:
Phone:
Email:
User Name:
Password:
IRS Status	Not For Profit For Profit

Agreement: Preliminary Application for FCLB PACE Recognized Provider Status We hereby initiate application to the Federation of Chiropractic Licensing Boards’ program entitled PACE (Providers of Approved Continuing Education - Chiropractic). We agree to comply with the FCLB PACE Policies & Procedures and FCLB PACE Criteria. The complete documents are available here. I Agree I Do Not Agree We agree to pay an initial application fee of $1,500 (US funds), payable to FCLB PACE. This initial application fee includes the first year’s recognition fee of $1,000 if our application is approved. If our application is NOT approved, $500 of this initial application fee is non-refundable, but the $1,000 first year’s recognition fee will be refunded.

Preliminary Application for Recognized Provider Status Establishment of Account