Activity Report Form
Certiﬁcation Maintenance Program (CMP)
Associate Continuing Education Tracking (ACET) Program
Please print all information below. An illegible or incomplete form will result in delayed processing.
Provided to you from the CMP Chair
Name of Approved Sponsor: UTRID
Number of CEUs
Activity Content Area
First time presenting this workshop
Yes - Please award GS CEUs
Instructor RID Member Number
Please attach a list of attendees in spreadsheet format. You can use the sample roster here:
By submitting this roster, I attest to the truthfulness of the content and that all individuals listed were in attendance.
Please type your name
I will email the evaluation resposes to
I would like to enter the summary online (continue to next section)
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