CPE PROGRAM ATTENDANCE RECORD Name: _____________________________________________________________________________________

Code A Courses: (Minimum 80 of the 120 hrs) Type Code

Course Title

Sponsoring Organization

Dates Attended/ Completed

Time Frame (Ex: 8 am to 5 pm)

Total Credit

Total Code A Courses:

Code B Courses: (Maximum 40 of the 120 hrs) Type Code

Course Title

Sponsoring Organization

Dates Attended/ Completed

Time Frame (Ex: 8 am to 5 pm)

Total Credit

Total Code B Courses: Calculate the grand total of Code A and Code B courses.

GRAND TOTAL:

Category Type Codes: IS: L: P: O:

CPE credits claimed for Independent Study (not the same as “Self Study”) are limited to 12 of the 120 credits CPE credits claimed for service as Lecturer or Discussion Leader are limited to 60 of the 120 credits CPE credits claimed for Published Articles or Books are limited to 30 of the 120 credits CPE credits claimed for all other courses (group, individual, self-study, etc.)

(For specific code definitions, please refer to Chapter 5 of Board Rules and Regulations) Rev. 4/2012

cpe program attendance record

CPE credits claimed for service as Lecturer or Discussion Leader are limited to 60 of the 120 credits. P: CPE credits claimed for Published Articles or Books are limited to 30 of the 120 credits. O: CPE credits claimed for all other courses (group, individual, self-study, etc.) (For specific code definitions, please refer to Chapter 5 ...

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