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: ______________________________________________
ERMONT
UPREME
OURT
OFFICE OF ATTORNEY LICENSING
BOARD OF MANDATORY CONTINUING LEGAL EDUCATION
