MLP Webinar Confirmation Form 2024

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This confirmation form should be completed any time you participate in a non-MLP industry-related webinar. In the absence of a face-to-face meeting, this form serves as your "sign-in" for the event, confirms your attendance, and helps us gather a little bit of information about the training you received.

In person training does not require this confirmation form. Please retain proof of your attendance or use the sign in form at the event (when available).

You will receive a confirmation email when you submit this form. Please retain that confirmation email for your records. These emails will serve as a reference when you complete your online recertification form. Webinars that you've completed can be listed on the online recertification form by title, date and # of credits.

Email *

First Name *

Last Name *

MCLP #: *

Title of webinar *

WEB ADDRESS of WEBINAR *

Presenter or name of Sponsoring Organization *

Webinar description - key points, overview of topic *

Date viewed *

YYYY

Duration of the webinar *

How did you hear about this webinar?

What was your most important takeaway from this presentation? *

Would you recommend this webinar to other MCLPs? *

I would NOT recommend this webinar

I would DEFINITELY recommend this webinar

From this presentatation: *

I did NOT learn anything new

I learned a lot of new information

The information presented *

Will NOT be useful for me in my job

Will be very useful for me in my job

What could be improved about this webinar?

THE NUMBER AND TYPE OF CREDITS I AM CLAIMING FOR THIS WEBINAR IS: *

0.5 Education * less than 1 hour

1.0 Education * 1-4 hours

2.0 Education * 4-8 hours

1.0 Safety * less than 1 hour

2.0 Safety * 1 hour or more

Other:

Any additional comments:

A copy of your responses will be emailed to the address you provided.

Submit

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