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CE Provider Online Application Form
 /  CE Provider Online Application Form

To be considered for course approval, please follow all instructions, and allow 30 days for a response from APTA Indiana. Providers may submit an application for approval up to six months after the course end date. Providers should not submit a course for approval more than six months prior to the initial offering date.

Click here for required materials to include with application


Provide the Following in Order

  1. Detailed course description *
  2. Specific, measureable learning objectives , related to the course description (at least 5, with at least one that refers specifically to a review of current evidence) * #
  3. Presenter(s)’ credentials/qualifications to teach the specific course material (full CVs required for primary presenters; bio – sketch CVs accepted for other presenters) *
  4. References, including at least 5 works within the past 10 years, of which at least 2 works must be within the last 5 years.* References should follow a professional formatting style, such as AMA or APA style, so that all necessary information to verify the accuracy of the reference is possible, including page numbers. For electronic resources, the same formatting style should apply; consumer websites are not acceptable as references. There should be a minimum of 3 references in the last 10 years (with 1 in last 5 years) for a 1.0-4.0 CEU course, or 5 in the last 10 years (with 2 in last 5 years) for a course with more than 4.0 CEUs. Recent references are important for providing participants with current knowledge.

    **EXCEPTION
    – All references for Indiana Jurisprudence must refer to the most recently published versions of Indiana’s statutes (Indiana Code) and rules (Indiana Administrative Code), which can be found on the state’s website.
  5. Detailed course agenda/schedule, justifying the requested contact hours (or for asynchronous course, a detailed explanation of instructional methods – discussion boards, videos, tests, documents to read, etc. – with expected time to complete each learning module) *
  6. Method for verification of attendance (e.g., participant signs in and initials out each day , and for each course in a conference/symposium , with time of each signature; or for asynchronous courses, a record of time elapsed in a course ) *
  7. Sample course and instructor evaluation form
  8. Sample course completion certificate , with room to note INAPTA approval number
  9. Method of assessing student learning

* Items 1 – 6 must be submitted for each individual course in a conference/symposium.
# For 1.0 – 4.0 contact hour courses, only 3 objectives and 3 references (1 in the last 5 years) are required.

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