Individual Application Form

Once submitted if you have not heard from a member of the MCLE Staff after 14 business days; please contact 801.746.5230

"*" indicates required fields

Name*
Email - Please enter the email address to be used for communication and confirmation replies.*
Attorney's Email - Please enter the address of the attorney if different.
Phone *
Program Sponsor *
Program Title *

Program Start Date *
MM slash DD slash YYYY

Program End Date *
MM slash DD slash YYYY

Requested Credit Type - Please select the type of CLE credit you are applying for.*

Enter the number of General MCLE credits being requested. If requesting lecturing general credits only enter the number of hours spent lecturing.
Enter the number of Ethics MCLE credits being requested. If requesting lecturing ethics credits only enter the number of hours spent lecturing.
Enter the number of Professionalism & Civility MCLE credits being requested. If requesting lecturing professionalism & civility credits only enter the number of hours spent lecturing.
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Max. file size: 128 MB, Max. files: 5.

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