EDUCATION AFFIDAVIT
FOR JUDICIAL EDUCATION HOURS OR CONTINUING LEGAL EDUCATION ATTENDANCE
(For Individual Courses Only)
Please fill out this form completely. Please note: This affidavit is a public record.
O
RGANIZATION PROVIDING EDUCATION:
NAME OF CONFERENCE /SEMINAR TRAINING:
Dates:
Location:
Total Number of Hours Offered:
Of this total, how many ethics hours offered:
Of this total, how many substance abuse/addictive disorders/mental health hours offered:
Of this total, how many domestic violence hours offered:
Total Number of Hours Attended:
Of this total, how many ethics hours attended:
Of this total, how many substance abuse/addictive disorders/mental health hours attended:
Of this total, how many domestic violence hours attended:
Total Number of Hours Reported to CLE Board/AOC Judicial Education:
Name: Title:
Judicial/Business Affiliation:
Mailing Address:
Telephone Number: Fax Number:
Email:
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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