MACP Attestation Form

MACP Attestation Form for Work/Volunteer Experience

Name: *

Name:

First

Last

Email *

Phone *

Program Start Month *

Program Start Year *

I attest that the following statement regarding the minimum 150 hours of relevant work and/or volunteer experience is true:

Attestation *

Yes, I meet the criteria at this time

Yes, I will meet the criteria before the term start

No, I do not meet the criteria but I will before the end of the first term

Signature *

Date: *

If you are human, leave this field blank.