Individual Application Form

Once submitted, if you have not heard from a member specialist after 14 business days, please contact 801.746.5230 or staff@mcleutah.org

"*" indicates required fields

Name*
Email - Please enter the email address to be used for communication and confirmation replies.*
Lawyer or Licensed Paralegal Practitioner's Email - Please enter the address of 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 half-hour increments. If requesting lecturing general credits, ONLY enter the number of hours spent lecturing.
Please enter a number greater than or equal to 0.
Enter the number of Ethics MCLE credits being requested in half-hour increments. If requesting lecturing Ethics credits, ONLY enter the number of hours spent lecturing.
Please enter a number greater than or equal to 0.
Enter the number of Professionalism & Civility MCLE credits being requested half-hour increments. If requesting lecturing Professionalism & Civility credits, ONLY enter the number of hours spent lecturing.
Please enter a number greater than or equal to 0.
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    Supporting documentation for your request is required.

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