EFTA00126049

<table><thead><tr><th colspan="5">MCC NEW YORK<br>TRAINING PARTICIPANT SIGN-IN LOG</th></tr><tr><th colspan="5">COURSE TITLE: Suicide Prevention/SHU Training COURSE CODE:</th></tr><tr><th colspan="5">TRAINING DATE(S): From: December 7, 2018 To: December 7, 2018 TOTAL TRNG HRS.</th></tr><tr><th colspan="5">TRAINING TIMES From: 9:00 To: 12:00 am</th></tr><tr><th colspan="5">INSTRUCTOR(S) NOTE: INSTRUCTOR(S) MUST ATTACH AGENDA OR SUMMARY OF TRAINING</th></tr></thead><tbody><tr><td>LAST NAME (PRINTED)</td><td>FIRST NAME (PRINTED)</td><td>BOP ID</td><td>SIGNATURE</td><td>OFFICE USE</td></tr><tr><td rowspan="14"></td><td rowspan="14"></td><td>G0109</td><td rowspan="14"></td><td></td></tr><tr><td>14997</td><td></td></tr><tr><td>44099</td><td></td></tr><tr><td>57355</td><td></td></tr><tr><td>60107</td><td></td></tr><tr><td>18797</td><td></td></tr><tr><td>18945</td><td></td></tr><tr><td>59463</td><td></td></tr><tr><td>59464</td><td></td></tr><tr><td>59282</td><td></td></tr><tr><td>52396</td><td></td></tr><tr><td>12.</td><td></td><td></td><td></td></tr><tr><td>13.</td><td></td><td></td><td></td></tr><tr><td>14.</td><td></td><td></td><td></td></tr><tr><td>15.</td><td></td><td></td><td></td></tr><tr><td>16.</td><td></td><td></td><td></td></tr><tr><td>17.</td><td></td><td></td><td></td></tr><tr><td>18.</td><td></td><td></td><td></td></tr><tr><td>19.</td><td></td><td></td><td></td></tr><tr><td>20.</td><td></td><td></td><td></td></tr></tbody></table>

By signing above you attest to not only attending the above named training course, but also to understanding the course material, policies and procedures pertaining to the training.

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