Thank you for your interest in applying for the Blue seal endorsement for your course or educational meeting.
Please complete the following application form, once complete the application will be reviewed by the E-AHPBA Secretary General, once approved the motion will be passed by the E-AHPBA Executive Committee.
To review the E-AHPBA Governance of Educational Activities document please click here.

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* 1. Please provide the Course or Educational Meeting Title:

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* 2. Please provide the Course or Educational Meeting website address:

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* 3. Please detail the subject matter for the course or educational meeting:

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* 4. Please detail the dates of the course or educational meeting:

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* 5. Please detail the host city and venue for the course or educational meeting:

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* 6. Please provide details of the host organisation:

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* 7. Please list the objectives for the course or educational meeting:

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* 8. Please list the names of the organising committee (including a note of those who are E-AHPBA members):

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* 9. Upload any supporting documents for the organising committee here:

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 10. Please provide a copy of the programme including proposed faculty:

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* 11. Upload any supporting documents for the scientific programme here:

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 12. Will CME be provided to course or meeting attendees?

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* 13. If the meeting is accredited, please name the CME provider:

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* 14. Is the course or educational meeting international, regional or national:

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* 15. Please confirm the level of discount on registration fees offered to E-AHPBA members:

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* 16. Is the meeting/course being hosted online?

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* 17. If so, what online platform will be used?

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* 18. If online, who will this be facilitated/managed by?

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* 19. Date of request:

Date

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* 20. Please provide contact name and email address for application liaison:

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