Provider Name Provider Number Title of Activity Location of the Activity City, State/Country/Remote Date & Time of the Activity Minimum Continuing Legal Education (MCLE) Credit Hours Awarded for the Above Activity: General MCLE Credit Hours Legal Ethics Credit Hours Recognition & Elimination of Bias Credit Hours Implicit Bias Credit Hours Prevention & Detection Competence Credit Hours Wellness Competence Credit Hours Technology in the Practice of Law Credit Hours Civility in the Legal Profession Credit Hours Total Credit Hours Below section is to be completed by the California Licensee and/or the Provider after participation in the activity Name of CA Licensee CA Bar Number Signature of CA Licensee Δ
