NJSBA CLE Form (NY, NJ, and PA) NJ, NY & PA ATTORNEY AFFIRMATION: MCLE CREDIT FORM By completing this form, I certify that I have attended this course in its entirety and request that I be awarded the applicable number of CLE credits. Please Enter Your Information: Your Name: * Your Name: First First Last Last Your Email: * Your Certification * By checking this box, you certify that the information below is accurate, and that you have attended this session. Product: Type (please select one): * Webcast/WebinarOn-Demand Video/CD/MP3/Podcast Date You Watched This Program: * CLE Code 1 CLE Code 2 CLE Code 3 CLE Code 4 CLE Code 5 CLE Code 6 CLE Code 7 CLE Code 8 CLE Code 9 CLE Code 10 CLE Code 11 CLE Code 12 By submitting this form, you will automatically earn NJ CLE credit(s) for this program. Please indicate the other credit types you would like to earn (if applicable): New York CLE Credit Pennsylvania CLE Credit (Must provide PA Bar ID Number.) CPE Credit (Where Applicable) Please Enter Your PA Bar ID Number: * Seminar Evaluation: Please evaluate this program on a 1 to 5 scale, where 1 = poor and 5 = outstanding. Course Content: Select One54321 Instruction: Select One54321 Written Materials: Select One54321 Physical Setting: Select One54321 Technology: Select One54321 Optional Feedback About The Program: Calling All Great Ideas! Looking for a program on a topic we don't have, or know a speaker that would be perfect for a program or topic? Please let us know! Topics And Speakers: Submit If you are human, leave this field blank. Δ
