To apply for contact hours, access documents and submit to Monica Mewshaw six weeks prior to the educational activity (Sajak Pavilion, Suite 255, firstname.lastname@example.org, office 443.481.1535, fax 443.481.4494).
Applications should include the following documents:
- Applicant Eligibility Verification (Required. Area highlighted in yellow only. To be completed by nurse planner.)
- Educational Activity Application (Required. To be completed by nurse planner.) Please make sure your application includes:
- A list of references for the presenter’s content
- A full program: Brochure/Agenda/Schedule (session times included)
- Promotional/advertising materials (with appropriate required statement shown on marketing materials, see policy NAD11.2.03)
- Biographical and Conflict of Interest (Required for nurse planners and speakers.)
- Provider Responsibility Agreement (Required for nurse planners only.)
- Educational Planning Table (Required). Use this guide, Making Learning Objectives SMART as a resource when writing your objectives.
- Evaluation (Required)
If your activity will have a sponsor, commercial support or a co-provider, you will need to select the corresponding form(s) from the list of documents below to complete your application packet. Not sure if you have a sponsor, commercial supporter or co-provider or even all three? Click on the forms, the definitions of each relationship are defined.