Learning Activity Accreditation Form
 
 
  Please complete the fields below:
     
  Name surname:
  SAPIK registration number:
  E-mail address:
  Date of application:
     
  Please complete the fields below:
     
  Title of learning activity:
  Type of learning activity (workshop, congress, degree, publication, article etc):
  Organisation/institution/person presenting the learning activity/journal/article:
  Qualifications or background of presenter/s:
  Contact person of learning activity:
  Email address of contact person:
  Website of the learning activity:
  Place and venue (if applicable):
  Date, time and duration of learning activity:
  Is the learning activity an HPCSA/other professional board accredited activity?
  If you said yes on the above question, indicate the CEU/CPD points allocated by the professional board and attach proof:
  Registration fee (if applicable):
     
  Please motivate/give reasons why you think the knowledge gained in this learning activity will be valuable/beneficial to you as a Kinderkineticist.
   
 
   
  Please Upload any Relevant Documents:
 
   
 
 
   
  Name and Surname:
 
   
  Date:
 
   
 


 
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