Class Presentation Schedule (LIC 446-12)

State of California Department of Insurance

Class Presentation Schedule

Department of Insurance
Curriculum and Officer Review Bureau - Education Unit
300 Capitol Mall
Sacramento, CA 95814-4309
Information: (916) 492-3064
www.insurance.ca.gov

LIC 446-12 (Rev. 1/2023)

Please note: Class Presentation Schedule is only required for Contact courses.

I am preparing this form as:

Instructions:

  • USE A SEPARATE SUBMISSION FOR EACH CLASS PRESENTATION.
  • To inform the Department of a new class, mark NEW box and provide all pertinent information below.
  • To notify the Department of a change to a class schedule previously submitted, mark CHANGE, give the original date, time, location and provide new information below.
  • To cancel a class previously submitted, mark CANCEL and complete information below.
  • Completed form must be received by the Department at least 14 days prior to the original class presentation. Subsequent presentations must be received at least 10 days prior to class presentation. No faxes will be accepted.
  • Late schedules may not be accepted and attendees may not receive continuing education credit.
  • The information provided below must match the information on the certificate of completion and the provider roster.
Check One

Location of Presentation

Daily Presentation Schedule

If course spans more than one day, each day must be listed in Daily Presentation Schedule chart below.

Provider Director Certification