*IC & RC HRS Form Generator

Use to make forms for clients

Name(Required)
Address(Required)
(number of hours needed for the next renewal period: 0, 5, 6, 14, 20, 36 or 40) (Zero gets entered for the 2 non-renewable credentials)
i.e. effective/issue date of the credential, which on limited credentials gets backdated a few days)
MM slash DD slash YYYY
This field is hidden when viewing the form
MM slash DD slash YYYY
This field is hidden when viewing the form
MM slash DD slash YYYY
This field is hidden when viewing the form
MM slash DD slash YYYY
MM slash DD slash YYYY
This field is hidden when viewing the form
MM slash DD slash YYYY
This field is hidden when viewing the form
MM slash DD slash YYYY
assigned credential number
Credential

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