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Apply for CPD accreditation
Course Name:
*
Provider:
*
Course Description:
When is the course being held?:
Flyer / Agenda / Documentation:
Course Duration:
Days:
Hours:
Where is the course being held?
Australia Wide
Adelaide
Brisbane
Canberra
Darwin
Hobart
Melbourne
Perth
Sydney
Regional NSW
Regional NT
Regional QLD
Regional SA
Regional TAS
Regional VIC
Regional WA
N/A - Online Program
Other
Please complete if other:
Method to Verify Attendance:
Marked Attendance List
Scanned Barcode
Other
If other, please specify:
Assessment Description:
*
Venue:
Who is presenting the course?
*
What are their qualifications?
*
Mode of Delivery:
eLearning
Seminar/Workshop
Convention/Conference
Learning Objectives and Outcomes:
*
I want NIBA to display my course on the NIBA Calendar ($49.95) :
Yes
No
Available To:
Private (in house/invitation only)
Public
Contact Details (displayed on CPD Register)
Contact Name:
Email:
Phone:
Website:
Registration Form:
Company Details (not displayed)
Company Name:
*
Legal Name:
*
ABN:
*
Company Address:
*
Contact Name:
*
Phone:
Email:
*
* Indicates a mandatory field.