NJCE LIVE - GROUP SIGN IN SHEET

If You Were Not with a Group and Attended On Your Own DO NOT SUBMIT THIS FORM.

Supervisor/Training Administrator: Please Complete this Form in its Entirety. Thank you

Please Submit within 24 Hours

* Questions with an Asterisk Must be Completed.

Question Title

1. Choose the Live Virtual Course Title: (Required.)

Question Title

2. Date and Start Time of the Course: (Required.)

Date / Time

Date

Time

AM/PM

Question Title

3. Agency (Employer): (Required.)

Question Title

4. Department: (Required.)

Question Title

5. Supervisor Information (Please Complete All Fields) (Required.)

First Name:

Last Name:

Email Address:

Phone Number:

Question Title

6. If you have a Water/Wastewater License # enter it below

Question Title

7. Did you attend the Training? (Required.)

Yes

Question Title

8. For Supervisor:
"I attest the submitted participants attended the entire course and were given the opportunity to ask questions about the material." (Required.)

Yes

Question Title

9. Registered Name (Zoom): (Required.)

First Name:

Last Name:

Question Title

10. Did you attend the training? (Required.)

Yes

Question Title

11. Number of Participants that Attended the Training (Number Only) Please Complete the Participants Information on the "NEXT PAGE" by Clicking the the Green Button Below. Thank you (Required.)

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50% of survey complete.

NJCE LIVE - GROUP SIGN IN SHEET

If You Were Not with a Group and Attended On Your Own DO NOT SUBMIT THIS FORM.

Question Title

* 1. Choose the Live Virtual Course Title: (Required.)

Question Title

* 2. Date and Start Time of the Course: (Required.)

Question Title

* 3. Agency (Employer): (Required.)

Question Title

* 4. Department: (Required.)

Question Title

* 5. Supervisor Information (Please Complete All Fields) (Required.)

Question Title

* 6. If you have a Water/Wastewater License # enter it below

Question Title

* 7. Did you attend the Training? (Required.)

Question Title

* 8. For Supervisor: "I attest the submitted participants attended the entire course and were given the opportunity to ask questions about the material." (Required.)

Question Title

* 9. Registered Name (Zoom): (Required.)

Question Title

* 10. Did you attend the training? (Required.)

Question Title

* 11. Number of Participants that Attended the Training (Number Only) Please Complete the Participants Information on the "NEXT PAGE" by Clicking the the Green Button Below. Thank you (Required.)

1. Choose the Live Virtual Course Title: (Required.)

2. Date and Start Time of the Course: (Required.)

3. Agency (Employer): (Required.)

4. Department: (Required.)

5. Supervisor Information (Please Complete All Fields) (Required.)

6. If you have a Water/Wastewater License # enter it below

7. Did you attend the Training? (Required.)

8. For Supervisor:
"I attest the submitted participants attended the entire course and were given the opportunity to ask questions about the material." (Required.)

9. Registered Name (Zoom): (Required.)

10. Did you attend the training? (Required.)

11. Number of Participants that Attended the Training (Number Only) Please Complete the Participants Information on the "NEXT PAGE" by Clicking the the Green Button Below. Thank you (Required.)