| First Name |
|
| Last Name |
|
| Title |
|
| Institution / Organization |
|
| Phone |
|
| Email |
|
|
| Primary Field of Practice |
|
| Secondary Field |
|
| Secondary Field |
|
| Secondary Field |
|
|
| Yes, I want MCLE credits |
( 5.75 MCLE credits possible ) |
|
Questions? Email Teresita Sablan: sablant@uchastings.edu
|
