Name of Organization * Address of Organization *
Please include building number, street number, street name, city, province, country, and postal code.
Contact Name *
Contact Email *
Contact Phone Number *
Please include country code.
Overview of Application *
Summary of the activity to be accredited (objectives, rationale, learning outcomes)
Please provide details for activities such as courses and webinars *
When will the event run? How long will the event run? What is the date of the event? What is the format of the event?
Why do you think HTAi should provide accreditation? * Tutor or Presenter Information
Please provide information on any associated tutors or presenters. This information is required for courses and webinars.
Attach a Short CV
Please ensure uploaded files are in .doc, .docx, or .pdf formats.
Tutor or Presenter Name
Affiliation Field of Specialization Teaching Experience Reason Why Suitable for This Activity Conflict of Interests Co-tutors or Co-presenters Co-tutors or Co-presenter Name
Please include given name and surname
Reason why suitable for this activity Activity Details Objective of the Activity Curriculum and Course Schedule (if applicable) Course Materials
Please submit materials in .xlsx, .docx, or .pdf format.
Language in Which Activity is Presented
Please note the pilot will be conducted in English language materials only.
Information Relevant for Participants or Readers Prerequisites to attend the activity and/or understand the materials
Which skills do participants acquire?
Course/Training Material Requirements
What is the time investment for participants, besides the actual course? What are the technical requirements to participate in the course?
Evaluation of the Course How do you plan to evaluate the activity and/or materials regarding its objectives? Costs Which fees would participants need to pay?
Please list the cost elements of the activity and explain how the fee amount is decided.
Impact of the topic on society and public debate Is the activity likely to provoke controversy within the Society?
This is a subjective commentary, but please can you highlight any areas of potential disagreement or contention regarding the core content of your material being assessed.
Does the activity have any ethical, legal, local, cultural or other external sensitivities?
This is a subjective commentary, but please consider any relevant sensitivities or issues that the Society should be aware of before accrediting your materials. Please keep in mind the ethos of the Society to be inclusive and neutral platform for all those involved in using and producing HTA.