Submit Digital Forms
Recommended if applying to Liberia Environmental Health Board
CPD Provider Registration Form
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* Name of CPD Provider
* Contact Person
* Job Title of Contact Person
* Phone Number of Contact Person
* Email Address of Contact Person
* Physical Address of Contact Person
* Website
* In which counties do you plan to provide CPD?
* Which term best describes your organization? Health AssociationTraining InstitutionGovernment MinistryBusinessInternational NGOCommunity-Based OrganizationHealth Facility Other, please describe:
Please submit the following along with your CPD Provider Registration Form:
[Required] Business registration or equivalent documentation (e.g. Council of Higher Education accreditation, MOH Sectoral Clearance, articles of incorporation, etc.). For organizations outside of Liberia, include documentation for both the CPD provider and partner organization in Liberia.
[Optional] Training plan, including course topics and description of target audience
[Optional] For registration renewals, reports or evaluations from previously-delivered CPD courses