In-House CLEE Course Completion

In-House CLEE Course Completion
Name of the Course*
POST #*
Date Started*

MonthDayYear
Date
Start Time*

Hour Minutes

AM/PM Option
Date Ended*

MonthDayYear
Date
End Time*

Hour Minutes

AM/PM Option
Number Attending*
Instructor*
Attendee list*
Upload Sign-in Sheet(s)*

Any name on a sign-in sheet that cannot be read WILL NOT get credit.
Cancelof
Person Submitting Form*

First NameLast Name
Email*
example@example.com
Daytime Phone*
Please enter a valid phone number.
Signature*

Clear
Official Use Only

_______________________________________________________________________________________________
Status
Notes
Reviewed By
Review Date
Should be Empty:

Official Use Only