CPE Accreditation Application Form
CONTINUING PROFESSIONAL EDUCATION
CHECKLIST OF REQUIREMENTS
- Duly accomplished application for Accreditation form (CPE Form No. 05-2008).
- Outline (Topic/s of Seminar) with number of hours.
- Resume of Speakers / Moderators/ Facilitators.
- Program of Activities (Should include the following: Time, Topic/s, Name of Resource Speaker/s, Facilitator/s, Reactor/s ).
- Evaluation Method
- Proposed Budget
Additional documents for 1st Application:
- List of Officers with Name, PRC #, Expiration Date of PRC Card & Position.
- Schedule of Scientific Seminar for the whole year.
a. Application should be filed forty-five (45) days prior to the conduct of program, activity, or source.
b. You must use the Attendance Sheet Form provided by the PRC.
c. Submit all documents in legal size.
d. Application should be filed in three (3) copies. (1 original and 2 photocopies)
FOR COMPLETION REPORT OF CPE PROGRAM, ACTIVITY OR SOURCE
- Duly accomplished Completion Report Form (CPE Form No. 07-2008)
- Attendance Sheet/s.
- Log In/Out Form
- Evaluation Form (One (1) sample only).
- Evaluation Summary.
- List of Lecturers / Moderators / Facilitators/ Reactors with PRC license number.
a. Completion Reports should be submitted within fifteen (15) days after the conduct of Training / Program.
LATE AND INCOMPLETE APPLICATIONS
WILL NOT BE ACCEPTED.
PDA CPE Email address: firstname.lastname@example.org
Click to view and download:
- Checklist of Requirements
- Flowchart of CPE
- List of Lecturers
- List of Moderators
- Log In / Log Out
- Sample Summary of EV & Proposed Budget
- Matrix of CPE Activities 1
- Matrix of CPE Activities 2
- Self Accreditation Form 1
- Self Accreditation Form 2
- Accreditation Form
- Evaluation Form
- Completion Report
- Summary of Evaluation
- Evaluation Sheet
- Attendance Sheet
- Topic Abstract Form