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1. Title of activity ... - Kuwait Institute for Medical Specialization

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Form II<br />

CME Center<br />

<strong>Kuwait</strong> <strong>Institute</strong> <strong>for</strong> <strong>Medical</strong> <strong>Specialization</strong><br />

Application <strong>for</strong> Accreditation <strong>of</strong> CME/CPD Programs – Academic Details<br />

Note: To ensure that there is sufficient time <strong>for</strong> prospective participants to be<br />

in<strong>for</strong>med and <strong>for</strong> them to make appropriate arrangements to attend, CME/CPD<br />

activities will be registered only if the completed Application Form and all required<br />

details are received by the CME Center 3 weeks be<strong>for</strong>e the start <strong>of</strong> the <strong>activity</strong>.<br />

CME/CPD organizers are requested to provide in<strong>for</strong>mation about the proposed <strong>activity</strong><br />

under the following headings, and to <strong>for</strong>ward it with the completed Application <strong>for</strong><br />

Accreditation <strong>of</strong> CME/CPD Programs – Administration Details to the CME Center <strong>of</strong> the<br />

<strong>Kuwait</strong> <strong>Institute</strong> <strong>for</strong> <strong>Medical</strong> <strong>Specialization</strong> (Use additional sheets, if necessary):<br />

<strong>Title</strong> <strong>of</strong> <strong>activity</strong>: …………………………………………………………………….<br />

Frequency <strong>of</strong> conducting <strong>activity</strong> (if to be repeated): …………………………………………<br />

Aims and objectives:<br />

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Content outline:<br />

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Scheduling <strong>of</strong> sessions (Annex copy <strong>of</strong> program schedule):…………………...………..<br />

Target audience: number and background: ……………………………………………<br />

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Names <strong>of</strong> resource persons (Lecturers, tutors, demonstrators etc.):<br />

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Plans <strong>for</strong> program evaluation: …………………………………………………………..<br />

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