This page is a substitute for the CCR-3 Roster.  By completing and submitting this form you attest that you have completed the form truthfully and attended 100% of the class session.

NOTE: Entries for this form are date/time stamped and the IP address of the submitter is logged.  The form needs to be completed during the last 10 minutes of the class to be valid.  Entries made before or after class may be discarded at the discretion of the CE Provider.  

This form may be disabled when entries are not supposed to be made at times such as before class or more than 30 minutes after class.