WASHINGTON STATE BOARD OF CONTINUING LEGAL …



MANDATORY CONTINUING JUDICIAL EDUCATION

Course Approval Form

Administrative Office of the Courts

Attn: Phil Zitzelman

1206 Quince Street SE(P.O. Box 41170(Olympia, WA 98504-1170( (360) 753-3365( Fax: (360) 956-5719

courts.

APPLICATION FOR APPROVAL OF CONTINUING JUDICIAL EDUCATION ACTIVITY FORM 1 (Revised 6/2015)

________________ ______________________________

Application Date E-mail of applicant

1. ________

2.

3. 4. 4. 5. 5.

6.

7.

8.

9.

10.

11. TIME SCHEDULE OF COURSE PRESENTATION

(Please attach agenda with detailed time schedule, including lunch(es) and all breaks, or enter that information below. Do not send course materials.)

|Time during which each |Subject of each segment |Faculty |Teaching techniques used in |Total number of minutes devoted |

|segment will be offered | | |each segment |to each segment |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

12.

[pic]

-----------------------

(office use only)

Approved ________General credits

_________Ethics credits

_________A/V CJE credits

_________Total credits

Name and address of applicant. (return address and telephone number)

[pic] CJE credit denied.

You may request a review of this decision by contacting Mr. Phil Zitzelman at Phil.Zitzelman@courts.

Sponsor of activity: (name of organization sponsoring the activity)

Title of educational activity.

___ Check here if audio or video tape.

Dates of each presentation. (For A/V, give date recorded.)

City/State of each presentation.

Name, professional/educational background and practical/teaching experience of faculty (or attached program agenda/brochure).

Targeted audience – professional background of invited registrants.

Describe materials to be distributed to participants. (Do not send course materials).

Description of physical facilities (check all that apply).

__ Classroom seating __ Theater seating __ Other – describe

Method of evaluation of program (check all that apply).

__ Participant critique __ Independent evaluator __ Other - describe

Sponsoring agency agrees (1) to allow the Mandatory Continuing Judicial Education, a member thereof, or such other person as it shall designate, to audit the program in question, and (2) to maintain a list of all Washington judges actually attending the program and to transmit such list to the Mandatory Continuing Judicial Education with thirty (30) days following the final presentation of the program, as listed on Page 1 of this form.

By: _________________________________________ Printed Name: ___________________________________________________

Title: _______________________________________ Date: ___________________________________________________

E-mail: _______________________________________

*Please use this space to establish the nexus for all or any portion of a seminar in a discipline other than legal, or, an educational program that does not, on its face, consist entirely of strictly judicial education. (The applicant must demonstrate the nexus between the nonlegal subject matter and the applicant’s legal work; e.g., a personal injury attorney can seek credit for a medical seminar.) Attach an additional sheet if necessary.

STANDARDS FOR APPROVAL

"Judicial education" shall mean education obtained by judicial officers directly aid in performing his or her specified judicial duties.

The course shall constitute an organized program of learning dealing with matter directly relating to judging the law, judicial ethics, including anti-bias and diversity training, and substance abuse prevention training.

INSTRUCTIONS

(Numbers correspond to questions on form.)

1. Complete name and address of sponsor or individual submitting application.

2. Complete name of sponsoring organization

3. Complete title for the program or activity exactly as it appears on promotional brochure.

4. List location for each presentation.

5. List dates for each presentation.

6. List each faculty member and relevant credentials.

7. Describe the target audience of the program.

8. Describe the written materials for the program.

9. Describe the physical facilities by using check-off boxes (or type in description).

10. Indicate method of evaluation by using check-off boxes (or type in information).

11. Provide agenda/brochure.

12. Sponsors sign, print name of applicant, and date the application.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download