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- Fill in your company name, address, city, state, zip code, phone number, and fax number as required.
- Provide your email address in the specified field; this is mandatory for processing your credits.
- Indicate whether you will keep the original form as your certificate of continuing education credits earned by checking the appropriate box.
- Review each session attended and fill in the hours for each session based on your attendance. Ensure that total hours do not exceed 11.25.
- Sign the form at the bottom to confirm accuracy and completion before saving it for your records.
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