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FPPTA Florida Public Pension Trustees Association CPPT Continuing Education Verification Form For the Year 2009 Designee Information: Name: ______________________________________________________________________ Company/Pension System: ______________________________________________________ Street Address: _______________________________________________________________ City: __________________________________ State: ____________ Zip: ________________ Phone: _______________________ E-mail: ________________________________________ Please mark the programs you have attended: 10 Continuing Education Units _____ FPPTA Trustees School, February 2009, World Golf Village, St. Augustine, Florida _____ FPPTA Trustees School, October 2009, Hyatt Coconut Point, Bonita Springs, Florida _____ FPPTA CPPT Continuing Education Trip to Stock Exchange, April 2009, New York 5 Continuing Education Units _____ State of Florida Police Officers & Firefighters Trustees School, May 2009, Tallahassee, Florida _____ NCPERS Annual Conference, May 2009, Hyatt Regency Century Plaza, Beverly Hills, California _____ FPPTA Annual Conference, June 2009, Boca Raton Restort, Boca Raton, Florida _____ State of Florida Police Officers & Firefighters Annual Conference, October 2009, Orlando, Florida _____ NCTR, October 2009, Renaissance Esmeralda, Indian Wells, California _____ NPEA, October 2009, Tradewinds Resort, St. Petersburg Beach, Florida _____ International Foundation of Employee Benefit Plans Annual Conference (various locations)

Designee Signature: __________________________________ Date: ________________________

CPPT Program Post Certification Requirements: After completing the CPPT Certification Program everyone must complete 10 Continuing Education Units annually or 30 Continuing Education Units over three years to maintain your CPPT Certification. An FPPTA Trustee School will be worth 10 units and any other educational function attended will be worth 5 units either with the FPPTA or an approved outside educational conference. We have presently approved participation in the NPEA, NCPERS, International Foundation of Employee Benefit Plans, and the Florida Division of Retirement including “Police and Firefighters Trustee’s School” and the Orlando Conference. Each recipient will be monitored yearly to insure that CPPT related education is in fact continuing. You are required to attend at least one FPPTA function per year. Post Certification Requirements will be monitored on a calendar year basis beginning the day you pass the advanced exam. Re-Certification Fee: Every three years after certification, there will be a recertification fee of $100. Three years after your date of certification the FPPTA office will forward an invoice for your convenience. If you have any questions please feel free to contact Kim Ryals at 800-842-4064 or by e-mail Mail CEU form to: FPPTA 2946 Wellington Circle East Suite A Tallahassee, Fl 32309 Phone: 800-842-4064 Fax: 850-668-8514 E-mail: