Form For Submitting Training Credit Hours

Please fill out the form below completely. If you have any questions or comments, please call Bill Callahan at 602-452-3409. If you are a Removal Review Member in addition to being a local FCRB Board member please indicate so in the Board Section of this form.

Name::
County::
Board::
Date Training Completed:	Calendar
Your E-mail Address::
Type of Training (Choose one from the list):
	Attended a conference, seminar, or workshop
	Observed juvenile court proceedings
	Spent time with case manager, juvenile probation officer, or police officer
	Toured a group home or residential facility
	Viewed a video tape
	Substituted as FCRB member on another board
	Read professional literature relating to issues of concern to the FCRB
	Substituted as an FCRB member on another board
	Attended FCRB "Brown Bag" lunch/informal training
	Attended CASA "Brown Bag" lunch/informal training
	Attended DES Training
	Assisted with new board member orientation training
	Presenter of recruitment information during community meeting
Other (Please Specify)::
Title of Training::
Number of Hours::
What were your expectations of this option?:
Did this training meet your expectations?:
How did this enhance your role at the FCRB?:
Would you recommend this option to others?
	Yes
	No
If you participated as a speaker and presented recruitment/outreach information regarding FCRB, please indicate who the audience was and how many people were in attendance.
Audience and Attendance::
Please add any additional comments or suggestions below:
Comments:

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