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E-AHPBA Education and Training - Application for the Silver Seal endorsement of a National Chapter course

Thank you for your interest in applying for the Silver seal endorsement for your National Chapter course.
Please complete the following application form, once complete the application will be reviewed by the E-AHPBA President, once approved the motion will be passed by the E-AHPBA Council.
To review the E-AHPBA Governance of Educational Activities document please click here.
1.Please advise the E-AHPBA Chapter that is applying for the endorsement:(Required.)
2.Please list the names of the organising committee (including a note of those who are E-AHPBA members):(Required.)
3.Upload any supporting documents for the organising committee here:
No file chosen
4.Please provide details of the host organisation:(Required.)
5.Please provide the National Chapter course title:(Required.)
6.Please provide the course website address:(Required.)
7.Please detail the subject matter for the course:(Required.)
8.Please detail the dates of the course:(Required.)
9.Please detail the host city and venue for the course:(Required.)
10.Please list the objectives for the course:(Required.)
11.Please provide a copy of the programme including proposed faculty:(Required.)
12.Upload any supporting documents for the programme here:
No file chosen
13.Will CME be provided to course attendees?(Required.)
14.If the meeting is accredited, please name the CME provider:
15.Is the course international, regional or national:(Required.)
16.Please confirm the level of discount on registration fees offered to E-AHPBA members:(Required.)
17.Date of request:
Date / Time
18.Please provide a contact name and email address for application liaison:(Required.)