Free Request for Credit, Non-JBE Sponsored Program - Nebraska


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http://www.supremecourt.ne.gov/forms/administrative/jbe/credit-request.pdf

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Nebraska Supreme Court Administrative Office of the Courts/Probation Judicial Branch Education

Judicial Branch Education 521 S. 14th St., Suite 200 Lincoln, Nebraska 68509 (402) 471-3072 (402) 471-3071 (fax) [email protected]

REQUEST FOR CREDIT for Online Education (Webinars) and programs not sponsored by JBE
Directions: Please complete BOTH PAGES of this form and attach a copy of the program agenda. Return this form to Judicial Branch Education at the address above so your JBE credits may be calculated and added to your transcript. Thank you for your assistance.

Employee Information Employee Name: ________________________________________________________ Title and Work Location: __________________________________________________ Program Information Program Title: ___________________________________________________________ Program Location & Date: _________________________________________________ Program Sponsor: _______________________________________________________ Number of JBE hours requested: ___________________________________________ Program Evaluation
The educational materials distributed at this program were helpful.
Agree Strongly Agree Agree Slightly Neutral Disagree Slightly Disagree Disagree Strongly

The location of this program added to the overall educational experience.
Agree Strongly Agree Agree Slightly Neutral Disagree Slightly Disagree Disagree Strongly

The sponsor of this program communicated with me in a timely and effective way.
Agree Strongly Agree Agree Slightly Neutral Disagree Slightly Disagree Disagree Strongly

I would recommend this program to others.
Agree Strongly Agree Agree Slightly Neutral Disagree Slightly Disagree Disagree Strongly

My attendance at this program will aid my in the performance of my duties
Agree Strongly Agree Agree Slightly Neutral Disagree Slightly Disagree Disagree Strongly

By checking this box and submission of this form, I hereby certify that the information it contains is true and correct. Date: __________________________________________________________________
Upon review of the information submitted on this form by the JBE Office, the original will be maintained in your file and the awarded credits will be entered into your record. Thank you.

FOR JBE USE ONLY: You have received _____ hours of JBE credit for your attendance at this seminar. JBE Authorization: ____________________________________________________

In the space provided below, please tell us the most important things or ideas that you are taking away from this program.

Was there a particularly outstanding speaker or topic at this conference? Who or what was it and what made it exceptional?

Are there speakers or topics which this conference should not have presented? Who or what and why?

Please relate any additional comments regarding this conference in the space provided below.