Info for Certificate & CE Units

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* 1. General Information:

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* 2. In lieu of a signed credit verification form, my initials indicate that the following information is true and accurate:

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* 3. By initialing here, I understand that the Conference did not receive prior  approval from the IBCLC (International Board of Lactation Consultant Examiners) for CERPs and that Team Dynamics will send me the information I need to apply independently for IBCLC CERP's with the IBCLC once they process the summary of the Conference Evaluations. If I do not need IBCLC CERPs, then I can disregard the information sent to me after the Conference.

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* 4. I am requesting continuing education credits for the following discipline:

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* 5. Please indicate, for your continuing education related to your license, the number of hours you were in attendance and actively participating at the Conference and certify the following information is true and accurate:

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