Continuing Education Chart
You should only fill out this chart if you have the number of hours specified on the official exam
announcement! Use as many of these charts as needed.
If filing online you must save this form to your computer, open it using Adobe Acrobat Reader, fill in
your information, re-save it, and attach it to your application by using "Other" as the type of
If filing a hardcopy application, this form must be included with your application.
Do not submit your Continuing Education Documentation at this time.
Topic Date # Hours Provider