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Download Individual Activity Forms

Individual Educational Activity

An individual educational activity refers to one educational event or effort such as a conference, a workshop or online material.



Ineligibility of Commercial Entities

As of August 31, 2009 per the ANCC Accreditation Program, a providing organization is ineligible for approval if it is a commercial interest. Commercial Interest (definition): An entity that produces, markets, sells or distributes health care goods or services consumed by or used on patients or that is owned or controlled by an entity that does the same.
 
Please consult with the Continuing Education Approver Unit (CEAU) at kani@illinoisnurses.com for clarification regarding eligibility.

 

Individual Educational Materials to Download:

 
Reference Material for Individual Activity Applications

Directions for Completing & Submitting an Application

Criteria Manual for Individual Activity Approval

Fee Schedule

2011 Panel Dates

2012 Panel Dates


Required Forms for Individual Activity Applications

Individual Educational Activity Application Form

Biographical Data Form- Planners & Presenters

Conflict of Interest Forms

Educational Activity Overview Form

Sponsorship Declaration Form

Certificate


Optional Forms for Individual Activity Applications  (download and use if applicable)

Independent Study- Addendum

Agenda - for activities over 3 hours

Evaluation Form- Live Presentation

Independent Study- Evaluation

Sample Co-Providership Agreement

Sample Sponsorship Agreement


Additional Resources

Sample Disclosure Statement

Writing Content and Objectives on the Educational Activity Overview Form

Acceptable Verbs Used on the Educational Activity Overview Form

Category of Evaluation (Section L of application) Definitions

Standards for Commercial Support and Disclosure

Mergener Formula- a method to calculate independent study hours

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