Professional Regulation Commission

ATTENDANCE SHEET

CPD COUNCIL OF/FOR ____________________

Title of the Program:

Date : Venue :
Topic/s: Time: Room:
PRC LICENSE EXPIRY DATE
NO. NAME SIGNATURE
NO. (DD/MM/YYYY)
1

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24
Certified Correct by: Concurred by:

______________________________ ______________________________
(Signature Over Printed Name) (Signature Over Printed Name)
CPDD-12-B
Rev. 00
June 29, 2020
Page 1 of 2
 CPD Provider’s Authorized Representative CPD Provider’s Authorized Representative
Date and Time: Date and Time:

CPDD-12-B
Rev. 00
June 29, 2020
Page 2 of 2