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and professional activities. Before submitting this form, contact the specific organization(s) from which you desire credit to learn their specific guidelines. A copy of the course/activity brochure or outline may be required. NOTE: Submission of this form is no guarantee that you will receive education credit from such outside entities. INSTRUCTIONS: 1. 2. Before the end of the class or activity, complete this form in its entirety. PLEASE PRINT OR TYPE. At the end of the class, give the form .

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