APPLICATION FOR CREDIT FOR INSTRUCTION AT AN
AOC
SPONSORED EVENT
Name of Conference/Seminar Training:
Title of session:
Date of session:
Subject matter taught:
Type of instruction (lecture, leading of discussion, panel presentation, etc.):
Number of clock hours spent TEACHING (at a single presentation of the course)
:
Number of CREDITS taught:
Number of clock hours spent directly in preparation for teaching (at a single presentation of the course). No more
than 3.0 credits may be allocated to preparation for each hour of actual instruction:
To receive credit for portions of the training you attended you must fill out the standard Certificate Course
Attendance Form. You may obtain a form by contacting the Judicial Education Unit at 775-687-9858 or
judicialed@nvcourts.nv.gov. Please also remember that you must submit a copy of the State Bar of Nevada’s
Form 5 to receive credit for instruction if you are an attorney judge.
Name: Title:
Judicial/Business Affiliation:
Mailing Address:
Telephone Number: Fax Number:
Email:
By signing below, I certify that I presented at the activity described above and am entitled to claim
credit
hours, which includes ethics credits.
Judge/Attorney Signature
Please complete, sign and return this form at the conclusion of the educational activity to:
Judicial Education Unit
Administrative Office of the Courts
201 South Carson Street, Suite 250
Carson City, Nevada 89701
Telephone (775) 687-9858 / Fax (775) 687-9850
judicialed@nvcourts.nv.gov
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signature
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