Submit your CLE online! www.wyomingbar.org Application for CLE Credit Applications for CLE Credit should be submitted immediately after course attendance. Applications submitted after March 1 for CLE activities completed during the previous calendar year shall not be accepted. Type of CLE credit for which you are applying: (Check one box only. ) Live (includes teleconferences and live webcasts) Self-Study - 6 hrs. maximum (includes online, audio or video) (6 hours only applicable for 2014 CLE programs) Legal Writing * 15 hours maximum (see Rule 5(c)) Pro Bono Public Service - 5 hours maximum (see Rule 5(d)) Please submit separate "Request for Pro Bono CLE Credit" Seminar/Article Name _________________________________________ Seminar Location _____________________________________________ Sponsor Name _______________________________________________ Date(s) of Seminar/Publication ___________________________________ The following credits are based on a: I apply for: Including: I instructed: 60-minute hour 50-minute hour For non-accredited courses, please enclose a course brochure or outline showing course description, topics, faculty, and actual lecture times. The Wyoming Board of CLE grants CLE credit on a 60-minute hour. The following jurisdictions grant CLE credit on a 50-minute hour: CO, FL, KS, MO, NY, OK, RI, WV, and WI. If you apply for credits based on a 50-minute hour, you will receive .83 of that credit in Wyoming. total CLE credit hours for attendance/legal writing ETHICS credit(s). (Ethics credits are included in the total CLE credit hours.) hours at this seminar, of which were ethics instruction. (Insert actual instruction time; however, triple credits will be granted for instruction.) number of instructors (Indicate the number of instructors and/or panelists including yourself.) Only applicable if applying for instruction credit Attorney Name ______________________________________________ Attorney Number _____________________________________________ Firm ______________________________________________________ Address____________________________________________________ City/State/Zip _______________________________________________ Phone _____________________________________________________ E-mail _____________________________________________________ Signature___________________________________________________ With this signature I certify under penalty of perjury that the above and foregoing information is true and correct. * Legal Writing · A copy of the article, as published, must be attached to this application. Check here if any of the information provided to the left is to be accepted as an official change of address. OFFICE USE ONLY Hours Credited: ______________ Date Credited: _______________ Staff Initials: ________________ Questions regarding this form or other CLE matters should be directed to Marie Ellis at (307) 432-2103 or mellis@wyomingbar.org. P.O. Box 109, Cheyenne, WY 82003 · (307) 632-9061 · Fax: (307) 632-3737 American LegalNet, Inc. www.FormsWorkFlow.com