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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the designated field at the top of the form. Ensure that your name is clearly written for identification purposes.
Indicate your experience by selecting one of the criteria options (I, II, or III) and filling in the corresponding hours. Refer to the guidelines provided for each criterion to ensure you meet the requirements.
For Criteria III, if applicable, specify your site visit hours by checking off the appropriate regions (Coastal, Piedmont, Mountain) and entering the number of hours spent in each.
In the Activity Details section, provide a title for your activity along with its date and location. Include a brief description that outlines what you learned or experienced.
If you are a Program Instructor or Interpreter, print your name and title, sign where indicated, and provide your contact information including phone number and email address.
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