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Fillable Verification Attendance Form FRM 0618

This verification of attendance form is used to claim continuing professional education (CPE) hours by providing the attendee's name, certification number, title and details of the program attended such as dates and hours earned, the sponsoring organization, program description and location. The form also requires the name and signature of the verifier or presenter to confirm completion of the program.

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Subash Chandar
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181 views

Fillable Verification Attendance Form FRM 0618

This verification of attendance form is used to claim continuing professional education (CPE) hours by providing the attendee's name, certification number, title and details of the program attended such as dates and hours earned, the sponsoring organization, program description and location. The form also requires the name and signature of the verifier or presenter to confirm completion of the program.

Uploaded by

Subash Chandar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Verification of Attendance Form

for Continuing Professional Education Activities

Name: Certification Number:

Title of Program/Course Attended:

Date(s): CPE Hours Earned:

Name of Sponsoring Organization:

Description:

Location:

Name of Verifier or Presenter:

Signature of Verifier or Presenter:

Instructions: Please complete all fields. Field descriptions are listed below.

Name: Name of individual claiming CPE Hours.


Certification Number: Certification Number of the applicable certification.
Title of Program/Course Attended: The title/name of the program, course or event for which CPE has been claimed.
Date(s): The dates for which the claimed program, course or event took place.
CPE Hours Earned: The number of CPE hours earned during the program, course or event.
Name of Sponsoring Organization: The name of the organization, company, school or group that held the program, course or event.
Description: A brief description of the program, course or event.
Location: Location that the program, course or event was completed.
Name of Verifier or Presenter: Name of the individual who is confirming completion of the program, course or event.
Signature of Verifier or Presenter: Signature of the individual who is confirming completion of the program, course or event.

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