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Continuing Education Request Form 691512 © Each licensee seeking credit for attendance at or participation in an educational program that was not previously approved by the board shall submit to
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To fill out form 69-15-12c for each licensee, follow these steps:
02
Start by providing the name of each licensee in the designated field.
03
Enter the address and contact information of each licensee.
04
Specify the license number and type for each licensee.
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Indicate the period of validity for each license.
06
Provide any additional information required, such as license endorsements or restrictions.
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Ensure all the information provided is accurate and complete.
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Review the form for any errors or omissions before submitting it.
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Sign and date the form to certify its authenticity.
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Submit the filled-out form to the relevant authority or department.

Who needs 69-15-12 c each licensee?

01
Any individual or business entity that holds multiple licenses and needs to provide information about each licensee should fill out form 69-15-12c for each licensee. This may include license holders in regulated industries, such as healthcare, transportation, or finance.
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69-15-12 c each licensee refers to the specific section of the licensing requirements for each individual licensee.
Each licensee is required to file 69-15-12 c as per the regulations.
To fill out 69-15-12 c each licensee, you need to provide all the required information as outlined in the form.
The purpose of 69-15-12 c each licensee is to ensure compliance with licensing regulations and provide transparency.
Information such as license details, contact information, and any relevant updates must be reported on 69-15-12 c each licensee.
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