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FPPTA Florida Public Pension Trustees Association CPPT Continuing Education Verification Form For the Year 2003 Designee Information: Name: ______________________________________________________________ Company/Pension System Name: ________________________________________ Street Address: _______________________________________________________ City: ________________________________________________________________ Phone: ________________ Fax: ______________ E-mail: ____________________ Program Information: Please mark the programs you have attended for the year 2003. ! ! ! FPPTA Trustees Schools: = 10 CEU UNITS _____ FPPTA Trustees School, February 2003, Amelia Island Plantation, Fernandina Bch., FL _____ FPPTA Trustees School, October 2003, Marriott Waterside, Tampa, Fl _____ FPPTA CPPT Continuing Education Trip, April 2003, NY ! ! ! Other Educational Programs: = 5 CEU UNITS _____ Police Officers and Firefighters Trustees School, March 2003, Tallahassee, Fl _____ NCPERS Annual Conference, June 2003, Denver, Colorado, Fl _____ FPPTA Annual Conference, June 2003, Gaylord Palms, Orlando, Fl _____ State of Florida Fire & Police School September, 2003, Tampa, Fl _____ NCTR, October 2003, Hilton, Orlando, Fl _____ NPEA, November 2003, Hilton, Destin, Fl _____ International Foundation of Employee Benefit Plans Annual Conference (various locations) ! ! ! Please attach a copy of a certificate of attendance or a registration form for each program you attended above. Designee Signature: _________________________________ Date: ____________ ! ! ! Return deadline is February 6, 2004. Enclosed is a return envelope for your convenience. ! ! !CEU UNITS After completing the CPPT Certification Program everyone must complete 10 Continuing Education Units or 30 CEUs over a three year period. You must attend at least one FPPTA function per year. ! ! ! FPPTA Trustees Schools = 10 units ! ! ! Other Educational Programs = 5 units Mail or fax: FPPTA 2946 Wellington Circle East, Suite A, Tallahassee, Florida 32309 800-842-4064 Fax- 850-668-8514

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http://www.fppta.org/FPPTA/Forms/082_CEUForm2003.pdf

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FPPTAFlorida Public Pension Trustees Association

CPPTContinuing Education Verification FormFor the Year 2003

Designee Information:

Name: ______________________________________________________________

Company/Pension System Name: ________________________________________

Street Address: _______________________________________________________

City: ________________________________________________________________

Phone: ________________ Fax: ______________ E-mail: ____________________

Program Information:Please mark the programs you have attended for the year 2003.!!!!! FPPTA Trustees Schools:= 10 CEU UNITS

_____ FPPTA Trustees School, February 2003, Amelia Island Plantation, Fernandina Bch., FL_____ FPPTA Trustees School, October 2003, Marriott Waterside, Tampa, Fl_____ FPPTA CPPT Continuing Education Trip, April 2003, NY

!!!!! Other Educational Programs:= 5 CEU UNITS

_____ Police Officers and Firefighters Trustees School, March 2003, Tallahassee, Fl_____ NCPERS Annual Conference, June 2003, Denver, Colorado, Fl_____ FPPTA Annual Conference, June 2003, Gaylord Palms, Orlando, Fl_____ State of Florida Fire & Police School September, 2003, Tampa, Fl_____ NCTR, October 2003, Hilton, Orlando, Fl_____ NPEA, November 2003, Hilton, Destin, Fl_____ International Foundation of Employee Benefit Plans Annual Conference (various locations)

!!!!! Please attach a copy of a certificate of attendance or a registration form for eachprogram you attended above.

Designee Signature: _________________________________ Date: ____________

!!!!! Return deadline is February 6, 2004. Enclosed is a return envelope foryour convenience.

!!!!!CEU UNITS

After completing theCPPT CertificationProgram everyonemust complete 10ContinuingEducation Units or30 CEUs over athree year period.You must attend atleast one FPPTAfunction per year.

!!!!! FPPTA TrusteesSchools = 10 units

!!!!! OtherEducationalPrograms = 5 units

Mail or fax:FPPTA2946 Wellington CircleEast, Suite A,Tallahassee,Florida 32309

800-842-4064Fax- 850-668-8514