Form 6 - Teacher Credit Request - State Bar Of Georgia
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1
2FORM 6
STATE BAR of GEORGIA
COMMISSION on CONTINUING LAWYER COMPETENCY
104 Marietta Street
Suite 100
Atlanta, Georgia 30303
(404) 527-8710
REQUEST FOR CLE CREDIT BY THE TEACHER OF AN APPROVED
CONTINUING LEGAL EDUCATION ACTIVITY
PLEASE NOTE: Regulation #5 under Rule 8-106 (B) applies specifically to in-house CLE activities.
1.
Name of Teacher: _____________________________________________________Telephone (___)______________
2.
State Bar of Georgia Membership Number:_______________________________________________________
3.
Teacher's Full Address (Include Firm's Name): _______________________________________________________
___________________________________________________________________________________________
4.
Name of CLE sponsor: ______________________________________________________________________
5.
Name of sponsor’s contact person:____________________________________________________________
6.
Sponsor’s full address (include Firm’s Name:_________________________________________________
7.
Title of CLE activity:________________________________________________________________________
8.
Date(s):____________________________________________________________________________________
9.
Location(s):________________________________________________________________________________
(city and state)
(city and state)
(city and state)
(city and state)
10. Is the Sponsor an Accredited Sponsor? YES____ NO____ 11. Has this CLE activity been approved? YES___ NO___
12. Did the teacher receive any compensation for teaching this CLE activity? YES____NO____
(NOTE: MCLE Credit is not available for paid teaching)
13. Please check one: Initial Presentation____ Repeat Presentation____
14. How long is the teacher’s presentation?______________minutes
15. The requested number of (A) Total CLE Hours as well as the portions of the total hours
devoted to (B) Ethics, (C) Trial and (D) Professionalism topics:
(A) ________ minutes = ____________ Total CLE Hours*
(Please round the hours to the
60
nearest one-tenth of an hour)
(B) ________ minutes = ____________ Total Ethics Hours*
60
(C) ________ minutes = ____________ Total Trial Hours*
60
(D) ________ minutes = ____________ Total Professionalism*
(Minimum of
60
(1) per calendar year)
*PLEASE SEE THE BACK OF THIS PAGE FOR THE REGULATIONS ON THE COMPUTATION OF CLE HOURS.
PLEASE SUBMIT THIS FROM AT LEAST 30 (THIRTY) DAYS IN ADVANCE OF THE CLE ACTIVITY
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