Free Court Interpreting Services Continuing Education Form - Kentucky

AOC-INT-2 Rev. 6-09 Page 1 of 1 Commonwealth of Kentucky Court of Justice www.courts.ky.gov

Court Interpreting Services Continuing Education Form

Statement of Attendance for Approved Continuing Education Court Interpreting Services Please Print Name: _________________________________________________________________________________________ Address: _______________________________________________________________________________________ City: _________________________________________________ State: __________________ Zip: ______________ Phone: _________________________________ Fax: __________________________________

Program Information Name of Program Attended:_________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________

Date(s) Attended: __________________________________________________________ Hours of Credit: ___________________________________________________________

Program Sponsor: ________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________

I hereby state the information on this form is true and correct to the best of my knowledge.

______________________________________________________ Signature

_____________________________ Date

Please include a copy of any certificates or other documentation provided by the program sponsor.

Mail to: Administrative Office of the Courts Court Interpreting Services 100 Millcreek Park Building 12 Frankfort, Kentucky 40601

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