Sponsor'S Request For Approval Of A Cpe Activity Form printable pdf download

NCSB Paralegal CPE

09/13

THE NORTH CAROLINA STATE BAR

BOARD OF PARALEGAL CERTIFICATION

217 E. Edenton Street

Post Office Box 25908

Raleigh, NC 27611

(919) 828-4620

SPONSOR’S REQUEST FOR APPROVAL OF A CPE ACTIVITY

Note:

If advance approval is desired, this application and supporting documentation must be submitted at least 45

days prior to the date on which the activity is scheduled.

1. Full Name of Sponsor:__________________________________________________________________________________

2. Name of Contact Person: ___________________________________________ Telephone (______)____________________

3. Address: _____________________________________________________________________________________________

4. Email Address: ___________________________________ Web Address: ________________________________________

5. Title of CPE Activity: __________________________________________________________________________________

6. Type of Activity:  Interactive computer program (on-line or on-demand)  Live program, presenters and attendees on-

site  Live audio-only (telephone) hook-up  Live audio and video transmission, with/without webcast  Group video

viewing

7. Date/Time of Live Activity: Begin (hour & date): _____________________ End (hour & date): _____________________

8. Location (city, state/country):____________________________________________________________________________

If activity will be shown at multiple locations and/or at multiple times, attach a list showing all times and locations.

9. The CPE activity ___ was / ____ was not open to and advertised to paralegals outside of the firm/company.

10. Sponsor’s request for number of CPE minutes (for computer programs, give running time):

Ethics, professional responsibility, or professionalism (including substance abuse):

_______________minutes

General/other (substantive law topics other than ethics, professional responsibility,

or professionalism):

_______________minutes

Total:

_______________minutes

11. Attach an agenda showing the amount of time allotted to each topic, describing the subject matter covered under each topic,

and identifying presenters by name and qualification.

12. The Sponsor agrees to provide attendees with a certificate of attendance accurately reflecting the CPE hours completed by the

attendee, and optionally can furnish an alphabetical list of attendees to the Board of Paralegal Certification within thirty (30)

days after the CPE activity.

13. The Sponsor represents that it will comply with the CPE rules of the Board of Paralegal Certification and conduct this CPE

activity substantially as advertised and presented in this request, subject to emergency substitutions and withdrawals.

14. The Sponsor acknowledges that this CPE activity may be disapproved and prior approvals of any CPE activity revoked for

violations of the rules or for failure to comply with the agreements and representations contained in this request.

15. ATTACH the $75.00 accreditation fee to this application, payable to NC State Bar Board of Paralegal Certification.

Date:______________________________ CPE Sponsor: ________________________________________________________

Signature: ___________________________________________________________

Title: _______________________________________________________________

Sponsor'S Request For Approval Of A Cpe Activity Form

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