Revised 03/11 New York State CLE Board www.nycourts.gov/attorneys/cle NEW YORK CLE CERTIFICATE OF ATTENDANCE mAY Be uSed oNLY For progrAmS ACCrediTed BY The NYS CLe BoArd ALL iNFormATioN muST Be eNTered BY The CLe provider This certificate is issued under §1500.4(b)(12) of the NYS CLE Program Rules and under §10(B) of the NYS CLE Board Regulations and Guidelines. By issuing this certificate, the CLE provider verifies that the attorney named below completed this program. Attorneys must retain their certificates of attendance for at least four (4) years from the date of the program. NAme oF ATTorNeY: TiTLe oF progrAm: dATe(S) oF ATTeNdANCe: (For self-study programs, indicate date attorney completed program.) LoCATioN (City/State): (For self-study programs, check “Not Applicable.”) Not Applicable FormAT oF progrAm: (Check only the format completed by the attorney to whom this certificate is issued.) TrAdiTioNAL Live CLASSroom FormAT videoCoNFereNCe Approved For NewLY AdmiTTed ATTorNeYS Note: Newly admitted attorneys may not earn credit through the formats below, except as provided in §2(F) of the Regulations. Audiotape videotape Teleconference Audio Cd dvd/video Cd videoconference Audio file video file webconference online audio online video other: (Describe below.) Live broadcast ATTorNeY’S meThod oF pArTiCipATioN: (check only one) group SeTTiNg or iNdividuAL /SeLF-STudY (including an attorney individually dialing in or logging in to a webconference, teleconference or webcast, or individually viewing/listening to a recorded program) LeveL oF diFFiCuLTY– the content of the course is appropriate for: (check only one) BOTh newly admitted and experienced attorneys (transitional / nontransitional), or experienced attorneys ONly (nontransitional), or newly admitted attorneys ONly (transitional) CrediT for ATTeNdANCe One hour of CLE credit consists of 50 minutes of instruction. (Introductory remarks, meals, breaks and other noneducational activities are not to be included in the computation of credit.) To calculate CLE credit, take the total number of minutes of instruction, divide by 50, and then round down to the nearest .5 credit hour. (For example, a 90-minute program equals 1.5 CLE credits; a 24-minute program equals zero (0) CLE credits.) CrediT for FACuLTY pArTiCipATioN (Experienced attorneys only) Award credit in accordance with §3(D) of the Regulations. Speaker panel member moderator Law competition faculty Enter number of credits earned in each category: Enter number of credits earned in each category: ethics and professionalism Areas of professional practice Skills ethics and professionalism Law practice management Skills Areas of professional practice In accordance with §10(B)(2) of the Regulations, for multiple breakout sessions, provider should attach a sheet indicating the sessions attended by the attorney. Law practice management CLE PROVIDER INFORMATION provider orgANizATioN: AddreSS: TeLephoNe: The CLe provider: (check only one) has been certified as an Accredited Provider by the NYS CLe Board, or has had this individual course accredited by the NYS CLe Board as Course # provider AgeNT SigNATure: priNT NAme: This certificate may NOT be used to award CLe credit to New York attorneys under New York’s Approved Jurisdiction policy. American LegalNet, Inc. www.FormsWorkFlow.com