Chapter Event Support Form

Required Information

Today's Date*

Chapter Name*

Submitter's Name*

Submitter's Email Address*

Event Title*

Date of Event*

Is this a multiple day event?*

Yes
No

If yes, please give full date range and time details here:*

Start Time*

:

End Time*

:

Time Zone*

Type of Event*

Virtual Event/ with live speaker
In-Person Event/Webinar with live speaker
ACRP-Generated Content (Online Conference Library or Webinar Replay)
Event not requiring contact hours (networking event, certification prep course., etc.)

Event Description*

Event Agenda*

Event Point of Contact for Attendees (Name & Email Address)

Do you want ACRP to provide registration support?*

Yes
No

Would you like to offer pre-approved ACRP contact hours for this event?*

By using our system for contact hour management, we provide a link for contact hour purchase that you will need to share with attendees. Attendees complete an evaluation form after the event which will generate a contact hour certificate automatically uploaded to the attendee’s ACRP profile.

Yes
No

Name of Speaker(s)

If multiple speakers, list all speakers separated by commas

Additional Event Information/Comments

If you are using an external registration platform, please provide the link below.

Request for Educational Content Approval for Contact Hours

Please include all contact hour information for this event as requested. If an original speaker, the content will be reviewed for approval; ACRP-generated content typically does not need approval.

Number of contact hours requested

Event Learning Objectives

Please include at least three objectives

Please upload final event materials here.

Email chapters@acrpnet.org if you have more files to share. More information may be requested if uploads provided are insufficient.

Drop files here or

Max. file size: 50 MB, Max. files: 2.

ACRP Contact Hour Activity Agreement*

Please review the statement below which must be agreed to by the chapter for your content to be approved. By agreeing to this statement, the chapter acknowledges that they will ensure that all speakers abide by these requirements and work with speakers if changes to presentations are needed.

The Association of Clinical Research Professionals (ACRP) is committed to providing professional development that maintains a professional standard of those engaged in clinical research. The purposes of the Continuing Competency requirements established by the Academy are that credential holders continue to; master new clinical research-related skills and techniques; enhance approaches to effective clinical research, both within their specified job role and beyond; further develop professional judgement; conduct clinical research in a safe and ethical manner.

As part of this commitment, ACRP requests that content is educational in nature and aligned with the ACRP Core Competencies, Detailed Content Outline (DCO) of the ACRP certification exams, and/or Hot Topics in the clinical research industry. The content should cover transferable knowledge and skills, not those specific to the workplace, such as company SOPs, protocols, or specific software.

Clinical Research product or service promotion of any type is prohibited. Company names, logos, websites, etc. cannot be inserted into the body of the presentation. They can be provided on the first or last slide of the presentation.

I have read the above statement and I can confirm that the content of this event meets the requirements set by ACRP.

Request for Online Registration Support

Complete this section if you would like ACRP to set up an event registration web page for your event.

Event Maximum Capacity for registration (if applicable)

Last Day to Register Online

Chapter Member registration fee

ACRP Member (no chapter) registration fee

Non-Member registration fee

Name

This field is for validation purposes and should be left unchanged.

Chapter Event Support Form

Chapter Event Support Request Form

Required Information

Request for Educational Content Approval for Contact Hours

Request for Online Registration Support