**REQUIRED DOCUMENTATION TO BE ATTACHED: COURSES THAT HAVE NOT
BEEN PREAPPROVED MUST HAVE ATTACHED AGENDA AND COURSE MATERIALS.
YOUR REQUEST WILL NOT BE APPROVED WITHOUT THESE DOCUMENTS.
Also, please note that this form does not serve as a Certificate of Attendance. Documentation must
be provided at the time you apply for renewal of your certification to show you attended the class. If
the sponsor does not provide you with a Certificate of Attendance, you must have the court-approved
Certificate of Attendance completed by the sponsoring entity.
I am submitting the above request for continuing education credit with the understanding
that I may be required to provide additional documentation as requested by the presiding
judge or his/her designee.
Applicant Signature: ______________________________Date: _____________________
Shaded area is for official use only
Approved Credit Hours ______ More Information Needed
Denied Reason ______________________________________________________