EAPA-SA CBD Application Form | EAPA-SA

APPLICATION FOR APPROVAL TO PROVIDE A CONTINUING PROFESSIONAL DEVELOPMENT (CPD) GROUP ACTIVITY

Please complete and submit to the CPD Approval Committee at EAPA-SA

CBD Application Form

NOTE: The programme for the Activity and the Presenter’s CV must be submitted with this application preceding the activity. No retrospective approval will be made.

A. Provider Information

B. Presenter/ Facilitator Information [if different from A]

Name

Conference, Congress/ Symposium

Activities [Indicate your estimate in terms of high, average, low or none and the duration in hours]
Participation
Knowledge
Skills Development

Workshop

Activities [Indicate your estimate in terms of high, average, low or none and the duration in hours]
Participation
Knowledge
Skills Development

Small Group Discussion/s

Activities [Indicate your estimate in terms of high, average, low or none and the duration in hours]
Participation
Knowledge
Skills Development

Information session/s

Activities [Indicate your estimate in terms of high, average, low or none and the duration in hours]
Participation
Knowledge
Skills Development
Location of activity (address, town and province)
Indicate which of the following best describe the value and purpose of the CPD activity: [Show with a X]

Administrative fee per activity

Please note: No application will be assessed without submitted proof of payment. No fee is payable where the event if offered at no cost to the participants.
The CPD application checklist
Note: If the application is for a series of activities such as monthly small group discussions then the list of the groups as must be attached.
If the activity/s is approved, I undertake to –
Max. file size: 64 MB.