CEU Attendance Sign-In
Please fill out so we can accurately record your CEU credit and keep your contact info for future information regarding this CEU
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Course Title *
Date of CEU Course *
MM
/
DD
/
YYYY
Time of CEU *
Time
:
Presenter Name *
Your First & Last Name *
Email Address *
Phone Number *
IDCEC # *
ASID/IIDA/IDC #
Would you like Certificate of Completion mailed to your office? *
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