CLPC DISTANCE LEARNING CERTIFICATES FORM
Fill in the required information below and click on the SUBMIT BUTTON.
Your certificates will be sent to you via email after we verify your PINS
First Name:
*
Last Name:
*
Email Address:
*
State License Number:
*
Session Attended Date:
*
Enter presenter PINs to claim your certificates
*
Presenter 1 PIN:
Presenter 2 PIN:
*
- Required Field
