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Learning Activity Written Summary

Last modified November 08, 2007 11:18 AM

This is the online form.

Use this form to request continuing education contact hours when the sponsor does not provide an attendance certificate. Examples are teleconferences, conferences, etc.

Provide the requested information and then click "Submit" below. You will receive a response via email.

Full Name (Required)

E-Mail (Required)

Former Name

Library Employer

Title of Program

Program Date(s)

Times

(beginning and ending)

Briefly describe how the program relates to your current or future job responsibilities.

Summarize what you learned.

I attended the program described and the information provided is true and correct to the best of my knowledge. (Required)

Yes
No

Attach a file

Attach a MS Word or other file, if necessary.

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