APPLICATION FOR ACBN APPROVAL FOR A NUTRITION SEMINAR

Thank you for your interest in seeking approval from the American Clinical Board of
Nutrition for your up-coming seminar.


An ACBN Approved Seminar means that your company has obtained a higher standard of recognition in that your
seminar is recognized by the ACBN.

Twelve (12) credit hours of nutritional instruction are required by our certificants one out of every two years. In order for a seminar to be approved, the organization putting on the nutrition seminar must:

A. The seminar must be submitted for approval by the ACBN Board thirty (30) days prior to the event.
B. The seminar must be sponsored by a college, university, institution, foundation or agency having status with an accrediting agency recognized by the U.S. Department of Education, or an agency having a reciprocal agreement
with the recognized agency.
C. All speakers must demonstrate to the ACBN Board sufficient expertise in the subject matter they are lecturing.
D. A Curriculum Vitae (must also show date of birth, institute where degree was gratned and date of degree)
E. Hour x hour content of their lecture
F. Disclosure if they are representing a product ore service. If they represent a product or company that will be mentioned in their lecture (Conflict of interest)

In order to be an ACBN approved seminar, please fill out the following application and return no later than
ninety (90) days prior to the seminar.

1. Name of Organization holding the seminar___________________________

2. Address of Organization________________________________

______________________________________________

3. Telephone Number______________________________________

4. Fax Number____________________________________________

5. Email Address_______________________________________

6. Date(s) of seminar_______________________________________

7. Location______________________________

8. Contact Person___________________________________________

9. List of speakers and their topic(s):

________________________________________________________________________


________________________________________________________________________

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10. How many CEs per lecture? _____ Entire program?__________

11. Letter from Sponsoring College/University/Other

BROCHURES ARE NOT ACCEPTABLE DOCUMENTS FOR PRIMARY SOURCE VERIFICATION;
HOWEVER THEY MAY BE SUBMITTED AS PART OF THE INFORMATION TO BE REVIEWED.

CHECK LIST OF REQUIRED DOCUMENTS TO SUBMIT:

1. Basic application (above)
2. Letter from college, university, foundation, institution or agency, as described above
verifying:
A. Their sponsorship of the seminar
B. The number of credit hours approved by them
C. States CE were applied

.
A. A curriculum vitae ( must also show date of birth, institute where degree was
was granted and the date the degree was granted)
B. Content of their lecture
C. Credit hours of their lecture (if known)
D. Disclosure if they are representing a product or service. If they represent
a product or company that will be mentioned in their lecture (Conflict of
interest).

4. There is an administrative fee as follows:
1-2 speakers - $50.00
3-5 speakers - $100.00
Each additional speaker over 5 - $10.00 each

Once

Additional
after the first two changes are $10.00 each.

Approval
the same administrative fee above.

Send all documents to:
ACBN Headquarters
Bonnie Sealock, General Manager
6855 Browntown Road
Front Royal, VA 22630
Telephone: 540 635 8844
Fax: 540 635 3669
email: acbn@comcast.net