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For information about the Board s CPD requirements go to our website at www. peps. ohio. gov/ContinuingEducation.aspx. YOUR OHIO P. E. P. S. REGISTERED NAME AS IT IS ON YOUR LICENSE DATE mm/DD SPONSOR / Provider Location Address City State ZIP P. E. NUMBER FOR CALENDAR YEAR Activity TITLE Description Instructor CPD hRs Earned FROM TO 2010 CPD CARRIED OVER MAXIMUM 15 TOTAL EARNED CPD The CPD credits listed herein are true and correct and accuratel.

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