CE Credit Statement of Compliance form (CARAIFA) Date *Member Association *Reporting PeriodJanuary 1st *to December 31st *Full Name *Middle InitialStudent ID# *This serves to certify that Mr./Ms./Mrs.participated, presented and/or moderated in the following:-CARAIFA Congress 10# of AttendancesAttendance DetailsRunning CreditsAssociation’s Local Congress 10# of AttendancesAttendance DetailsRunning CreditsMDRT Meeting 7.5# of AttendancesAttendance DetailsRunning CreditsLAMP 5# of AttendancesAttendance DetailsRunning CreditsOne-day Seminar by local assoc. / company 3# of AttendancesAttendance DetailsRunning CreditsAssociation blast-off 3# of AttendancesAttendance DetailsRunning CreditsCompletion of CARAIFA Courses 15# of AttendancesAttendance DetailsRunning CreditsModerator 10# of AttendancesAttendance DetailsRunning CreditsParticipant in Congress Speaker’s Forum 2.5# of AttendancesAttendance DetailsRunning CreditsSIGNED Attendees at Congress Speaker’s Forum 1.5# of AttendancesAttendance DetailsRunning CreditsAttendance at two (2) accredited workshops at congress 2.5# of AttendancesAttendance DetailsRunning CreditsRelevant non-CARAIFA Courses (20 hours) 7.5# of AttendancesAttendance DetailsRunning CreditsAMTC Original Course i.e. 23 weeks x 3 hrs per week = 69 hrs# of AttendancesAttendance DetailsRunning CreditsAny person who serves as teacher, speaker or moderator panellist in an educational meeting e.g. seminar or workshop earns one credit for each 30 minutes of participation activityAttendance DetailsRunning CreditsTotal Credits for the periodTotal CreditsName of StudentSignatureDateEndorsement of Insurance Association:Choose FileNo file chosenDelete uploaded fileI certify that the information above is true and correct. (Place Association stamp here)Name of StudentAssoc. Authorised SignatureTitle heldTermCARAIFA ApprovalAuthorised SignatureTitle heldTermN.B. Applicant pay US $60 for CE Credits for each reporting period (24 months). Send Message
