MASTER LOGGER PROGRAM Continuing Education Report Form

To remain current as a Master Logger, eight hours of continuing education credits must be submitted prior to the certification expiration date.

Please complete the following as applicable and return to:

Washington Contract Loggers Association, Inc. P.O. Box 2168, Olympia, WA 98507-2168 (800) 422-0074 Tami Au, Ext. 103 or Jerry Bonagofsky, Ext. 113

Name ______Certification # ______

Employer ______

Address______

City ______State ______Zip ______

Business Phone ______Home Phone ______

Conference, Course, Seminar Credit Dates Location of Event Verified by*** attended Hours* Attended Washington Logging Safety Conference WCLA Annual Conference

Oregon Logging Conference Washington State Governor’s Safety & Health Conference Associated Oregon Loggers Annual Conference Pacific Logging Conference Intermountain Forest Industry Association Annual Meeting WCLA Chapter Meeting

Olympic Logging Conference Continued on back

Conference, Course, Seminar Credit Dates Location of Event Verified by*** attended Hours* Attended

Forest Products Safety Conference Society of American Foresters Meetings Farm Forestry Association Meetings

Intermountain Logging Conference American Society of Safety Engineers Meetings Dept. of Labor & Industries Workshops DNR Training Seminars

WSU Extension Courses Completion of High School or College Level Courses First Aid **** Public and Community Service (City Council, School Board, etc.) WCLA and other Organization Board Member Meetings Washington Forest Protection Association Meetings Other**

* One hour of instruction or service generally equals one hour of credit. Submit a copy of the meeting agenda/registration form so we can determine the proper number of credits to apply. ** Other continuing education programs are subject to approval for the awarding of credits. Please call WCLA for additional information at (800) 422-0074 - Tami Au, Ext. 103, or Jerry Bonagofsky, Ext. 113. ***Attendance can be verified by a signature of instructor, copy of agenda/meeting notice/registration form. ****First Aid training is worth a maximum of four c/e credits every two years.