OFFICIAL RECORD OF PARTICIPATORY MCLE ACTIVITIES

To print out this form, click on the printer icon, or on File, Print from your top menu bar

Participating Attorney's Name:

Office Street Address:

City:                                                            State:             Zip:                         Fax: (       )                           

Bar Number:                                          State:

Daytime Phone: (       )                                          Email Address:

MCLE credit hours shown are based on the New York 50-minute hour standard

Date of Activity	Time Start: End:	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	1.5 hours	.	.
.		Alternative Dispute Resolution	1.5 hours	.	.
.		Substance Abuse and Chemical Dependency	1.5 hours	.	.
.		Eliminating Gender Bias in the Legal Profession	1.5 hours	.	.
.		Emotional Stress & Distress	1.5 hours	.	.
.		Eliminating Legal Malpractice	1.5 hours	.	.
.		Unbundling-Limited Scope Legal Services	2.1 hours	.	.
.		Ethical Aspects of Attorney's Fees	3 hours	.	.
.		Client Trust Accounts	3 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 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 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 give original to provider: C.C.I.'s Institute for Continuing Legal Education, 3380 S. Wynn Road, Suite A., L.V., NV  89102.     Keep a copy for your records.

To print out, click on the printer icon, or on File, Print from your top menu bar

To register now and start earning ALL your biennial MCLE hours & subjects, click here.

To return to the general information page, click here    |   To return to the New York On-Line Main/Index Page, click here

To register and begin earning your MCLE credits now, click here