Official Record of Participatory MCLE Activities

OFFICIAL RECORD OF PARTICIPATORY MCLE ACTIVITIES

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Participating Attorney's Name:

Office Street Address:

City: State: Zip: Fax: ( )

Bar Number: State:

Daytime Phone: ( ) Email Address:

Date of
Activity

Time
Start: End:

Location of Activity

MCLE Activity Subject/Title

MCLE
credits

Signature of
Participating Attorney

Signature of
Provider's Agent

.
.
A,B,C's of Legal Ethics, Plus D and E

1.25 hours
. .

.
.
Alternative Dispute Resolution

1.25 hours
. .

.
.
Substance Abuse and Chemical Dependency

1.25 hours
. .

.
.
Eliminating Gender Bias in the Legal Profession

1.25 hours
. .

.
.
Eliminating Legal Malpractice

1.25 hours
. .

.
.
Unbundling-Limited Scope Legal Services & Emotional Stress

3.0 hours
. .

.
.
Manage Your MCLE Requirements

1.25 hours
. .

.
.
Ethical Aspects of Attorney's Fees

2.5
hours
. .

.
.
Client Trust Accounts

2.5
hours
. .

CERTIFICATION OF PARTICIPATING ATTORNEY: I, the undersigned, hereby declare on my oath as an attorney that the foregoing is a true and accurate record of my time spent on the indicated participatory MCLE activities.

DATED: _________________ SIGNATURE: ___________________________

CERTIFICATION OF PROVIDER'S AGENT: I, the undersigned, acting as the agent for the MCLE provider, C.C.I.'s Institute for Continuing Legal Education, hereby declare that the foregoing is a true and accurate record of the above-named attorney's time spent on the indicated participatory MCLE activities.

PRINTED NAME OF PROVIDER'S AGENT:

DATED: _________________ SIGNATURE: ___________________________

Instructions: Participating attorney and provider's agent sign attorney in and out for each participatory activity. Upon completion of MCLE activity participation, attorney and provider's agent sign and date certification at bottom of Official Record, then mail original to provider: C.C.I.'s Institute for Continuing Legal Education, 9424 Darwell Drive, L.V., NV 89117-0602. Keep a copy for your records.

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Date of Activity	Time Start: End:	Location of Activity	MCLE Activity Subject/Title	MCLE credits	Signature of Participating Attorney	Signature of Provider's Agent
.		.	A,B,C's of Legal Ethics, Plus D and E	1.25 hours	.	.
.		.	Alternative Dispute Resolution	1.25 hours	.	.
.		.	Substance Abuse and Chemical Dependency	1.25 hours	.	.
.		.	Eliminating Gender Bias in the Legal Profession	1.25 hours	.	.
.		.	Eliminating Legal Malpractice	1.25 hours	.	.
.		.	Unbundling-Limited Scope Legal Services & Emotional Stress	3.0 hours	.	.
.		.	Manage Your MCLE Requirements	1.25 hours	.	.
.		.	Ethical Aspects of Attorney's Fees	2.5 hours	.	.
.		.	Client Trust Accounts	2.5 hours	.	.