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Attendance Verification

Participant’s Name :
[certificate_student_field] [certificate_student_field]
Participant AGD ID #:
[certificate_student_field]
Course Title:
Smile Design
AGD Subject Code:
780
CDE Hours:
6
Speakers Name:
Dr Ron Goodlin
Location:
Smiles First Academy (Online Platform)
Verification Code:
SD0721
keep this form for your records
AGD Members: SMILES FIRST ACADEMY will submit attendance verification to the AGD on your behalf. Please allow at least 30 days for your documentation of participation to be added to your transcript.

Authorized Signature

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