Yearly CPD Course Application Form

Please ensure you have:

• Include a full programme of the meeting, including an hourly breakdown and details of the sessions
• Include a complete list of the speakers and include their CVs or a short biography, for each, listing the posts they hold, where they are based and what qualifications and experience they have, particularly in relation to the topic to be presented.
• Completed all sections in this application form, and sign the “declaration of conflict of interest”
• paid the course submission (or resubmission) fee
• For courses that will be running for the 2nd or 3rd time, please provide summary feed back receive from previous course participants

PLEASE NOTE: Organisers of approved events are required to:

• keep a record of the names of the people who attended
• provide attendance certificates to participants
• provide evaluation forms to the delegates and the FFLM on request (up to 2 years after the event has taken place)

The following guidelines are not exhaustive but are intended as guidance for course organisers when applying for FFLM accreditation of CPD activity.

If the organiser or any of the speakers have any potential conflicts of interest (vested interests) these must be declared on the CPD application form. It should be noted however that potential conflicts of interest will not, in themselves, prevent a course from receiving CPD accreditation provided that the primary purpose of the event is demonstrably educational and any sponsorship or commercial interests are shown not to be influencing the structure or content of the event.

A conflict of interest exists where an individual or organisation engaged in the provision of CPD has an interest in a commercial or other organisation which may compete with the individual’s duty to act independently in the provision of the educational activity.

Conflict of interest may occur in relation to any of the following links with a third party company or organisation where that body has a commercial interest in the CPD activity being held, for example as a provider of products or services that might be of interest or relevance to the course attendees or that might want to influence the views of target audience. Such a link may be direct, or through an immediate family member

1. A current or recent ownership interest (including holding stock or shares) of the organizers or speakers in such a company
2. Employment (extending to Board positions) or contract to provide services (including acting in a consultative or advisory capacity)
3. Receipt of financial or other support (including funding research, hospitality, travel or accommodation costs) provided to organizers or speakers or organisations in which they may have an interest (such as companies, departments or charities)
4. Payment for a representative of the company to attend or speak at the CPD event
5. Sponsorship of the event or regular sponsorship of other events held by the organisers
6. Any other commercial arrangement that might benefit the course organisers or speakers, either directly or indirectly

I/We have read and understood the FFLM guidelines regarding conflict of interest.

I/We have declared and submitted all information about any potential conflict of interest in accordance with the guidelines.

I/We agree that I/we have provided all of the requested information regarding the sponsorship of the applied for event/s and have been accurate about the status of our organisation (not-for-profit/for-profit).

THIS DECLARATION MUST BE COMPLETED AND SIGNED BY THE COURSE ORGANISER