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To be submitted for CE credit per KRS 147A.027

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* 1. Your Name

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* 2. Please provide your email address so that Staff can email your updated CE report.

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* 3. Your Jurisdiction

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* 4. Your position or role?

You may enter up to four (4) CE courses you have viewed or attended.  
If you need to report more than four courses, please submit an additional form.  Thank you!

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* 5. Enter CE course information below.

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* 6. Enter CE course information below.

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* 7. Enter CE course information below.

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* 8. Enter CE course information below.

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* 9. You may attach certificates here.  

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 10. By submitting this form I certify that I have attended or viewed all training listed above.

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