Thank you for your interest in hosting an E-AHPBA led course. 
Please complete the following application form to host an E-AHPBA Platinum or Gold Seal course, 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 Activites please visit the click here.

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* 1. Please indicate the course seal that the course application is for:
For more information on the different categories please visit the website - http://eahpba.org/education-and-training/educational-activities/

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* 2. Please provide the proposed Course Topic:

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* 3. Please provide the contact information for the Local Course Chair:

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* 4. Please upload the CV of the Local Course Chair:

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 5. Please summarise the proposed course themes identifying any potential speakers if relevant:

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* 6. Please upload the draft course programme (if available):

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 7. Preferred Dates of Course:
If possible please provide a selection of options

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* 8. Please advise the closest airport, train station and any other relevant transport information to the proposed course venue:

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* 9. Please provide a summary of approximate costs involved (venue, transportation, hotel etc):
E-AHPBA will produce a detailed budget should the course be selected, therefore only approximate costs are required at present

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* 10. Date of request:

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