CITIZEN REVIEW BOARD Education Credit Form For Citizen Review Board Members only. Citizen Review Board members are mandated under Oregon Revised Statute 419A.092 to receive eight hours of training annually. Please use this form to document and submit your required training throughout the year. Use a seperate form for each training you attend.

	02/09/2010	*Required Field
	First Name:	*
	Last Name:	*
	County:	*
	Board:
	Title of Training:	*

		Type of Training (choose one): *
		Attended DHS quarterly meeting Observed juvenile court proceedings Spent time with case manager or juvenile probation officer Toured a group home or residential facility Assisted with volunteer orientation Attended CRB 'Brown Bag' lunch/informal training Attended Juvenile Court Improvement Project (JCIP) training Viewed approved videotape Listened to approved audiotape Read professional literature relating to issues that concern CRB Attended conference, seminar, workshop other than JCIP training, Other (please specify):

	Date training completed:	*(mm/dd/yyyy)
	Number of hours:	*
	What did you expect of this training?
	Did it meet your expectations?
	What was most valuable?
	What did you like least about the training?
	Is this training related to cultural responsiveness issues?	----- Yes No *
	Would you recommend this training to others?	Yes No Not Sure

		To manage your training hours throughout the year, please print this form prior to submitting.