CERTIFICATE OF COMPLETION
LICENSEE'S NAME: LICENSE NUMBER:
ACTIVITY TITLE: DATE OF ACTIVITY:
ACTIVITY NUMBER: EDUCATIONAL ACTIVITY: HOURS
ATTENDED:
HOURS EARNED: BRANCH: TECHNICAL/GENERAL
THIS IS TO CERTIFY THAT THE ABOVE NAMED LICENSEE HAS
SUCCESSFULLY COMPLETED THE ABOVE NUMBERED ACTIVITY.
____________________________
INSTRUCTOR'S SIGNATURE
DATE
NOTE: DO NOT SEND THIS CERTIFICATE TO THE BOARD.
The above hours are approved for Structural Pest Control Board
license renewal. Original continuing education certificates are
subject to Board audit and should be RETAINED by you for
three years.
____________________________
43M-38 (NEW 5/87))
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