1. Received: ________ AM4: __________
FOR OFFICE USE ONLY
Los Angeles Chapter Linked: __________
Meeting Information CPE Checklist Eblast#1: ________ Eblast#2: _______
EVENT INFORMATION
Date: Registration Time: Presentation Time: Select Group: Select One
Topic:
SPEAKER INFORMATION
Name: Title:
Firm Name:
Firm Address:
Phone #: Email Address:
Audio/Visual Needs:  Projector  Screen Bio:  Bio E-mailed
SECOND SPEAKER INFORMATION
Name: Title:
Firm Name:
Firm Address:
Phone #: Email Address:
Audio/Visual Needs:  Projector  Screen Bio:  Bio E-mailed
CPE INFORMATION (Contact Delia; Please note: Pre-approval needed from CPE Development for CFP, MCLE and Gov’t credit.)
Check All:  CPE  CFP  MCLE  A&A  Fraud  Gov’t  1 hr.  2 hrs.  3 hrs.  Other ____________
Curriculum (Select up to THREE; one from each column):
Select One Select One Select One
Field of Interest (Choose one):
 Accounting  Communications  Personnel/HR
 Accounting (Governmental)  Computer Science  Production
 Administrative Practice  Economics  Regulatory Ethics
 Auditing (Governmental)  Finance  Social Environment of Business
 Auditing  Management Advisory Services  Specialized Knowledge and Applications
 Behavioral Ethics  Marketing  Taxes
 Business Law  Mathematics  Statistics
 Business Management & Organization  Personal Development
Level:  Update  Beginning  Advanced  Intermediate
Marketing (Summary of program):
Designed for:  Attorneys  Bankers  CPAs  Enrolled Agents  Financial Planners  Insurance Agents  Real Estate Agents
s
 Professional Staff  All of the Above  Other
Objective (What the participant will learn):
1. Learn
2. Gain
3. Understand
Major Subject/Talking Points (Items speaker will cover):
Prerequisites: Some knowledge of topic preferred.  None
Adv. Prep.: Some knowledge of topic preferred.  None
Please bring to the meeting.  None
SUBMIT TO: Delia Rincón • delia.rincon@calcpa.org (preferred) • 330 N. Brand Blvd., Ste. 710, Glendale, CA 91203 • FAX: (818) 246-4017
UPD
Certificate & Evaluations must be handed out at the end of each meeting. Information necessary in order to process CPE credits
DUE 1st of the month prior to the meeting date.