PROVIDER’S

LOGO

Certificate
Presented to

NAME
as

ROLE
(if Resource Person, include the topic discussed or presented)

on the

TITLE OF THE PROGRAM

VENUE
DATE OF CONDUCT
PROGRAM ACCREDITATION NUMBER
APPROVED CREDIT UNITS

SIGNATURE OVER PRINTED NAME

(DESIGNATION)

CPDD-14
Rev. 00
June 29, 2020
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