900-00009 – Application for Accreditation of Continuing Legal Education Activity (03/2020) Page 1 of 1
Application for Accreditation of Continuing Legal Education Activity
Instructions
To review for credit, you must attach:
̵ Program time schedule or agenda
(times are required to compute approvable credit hours)
̵ Table of contents or equivalent
̵ Faculty name(s) and credentials (if not in brochure or description)
No fee is required with the application unless submitted more than 30 days after the CLE activity, in which case you
must include a check for a late fee of $50, made payable to Vermont MCLE Board.
Please allow 3 to 4 weeks for processing.
Sponsoring Organization
Name of Organization: ___________________________________________________________________________
Address: __________________________________________ City/State/Zip: _________________________________
Email Address: _____________________________________ Telephone: ___________________________________
Program Description
Title of Program: ___________________________________________________________________________________
Date of Program: ________________________________
Target Audience: Attorneys Clients Other
(specify): ____________________________________
Type: Moderated Programming: programming delivered via a format that provides attendees an opportunity to
interact in real time with program faculty members or a qualified commentator who are available to offer
comments and answer oral or written questions before, during, or after the program.
Non-Moderated Programming with Interactivity as a Key Component: programming delivered via a recorded
format that provides attendees a significant level of interaction with the program, faculty, or other
attendees.
Non-Moderated Programming Without Interactivity: programming delivered via a recorded format that
does not have interactivity built into the program recording or delivery method.
Other ___________________________________________________________________________________
Description of Materials: _____________________________________________________________________________
Total minutes of instruction (d
o not include breaks, meals, keynote speeches or introductions): __________
Breakdown by Type: General: __________ Attorney Wellness: __________
Ethics: __________ Diversity and Inclusion: __________
Submitted by:
Sponsor/Provider
Sponsor Representative: ___________________________________________________________________
Individual Attorney
Attorney Name: ____________________________________________________________________________
Email Address: ____________________________ Telephone: __________________________________
Date: ______________________ Signature: ______________________________________________
V
ERMONT
S
UPREME
C
OURT
OFFICE OF ATTORNEY LICENSING
BOARD OF MANDATORY CONTINUING LEGAL EDUCATION