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Individual Educational Activity Application for ICEA Contact Hours

  • Application Instructions

    Please complete the application below for ICEA contact hours. If approved, you will be invoiced $25 per contact hour awarded. If you have any questions, please contact info@icea.org/.
  • Applicant or Organization Information

  • Primary Contact Information

  • Educational Activity Information

  • MM slash DD slash YYYY
  • Include all time for introductions, breaks, meals, and non-CE content time.
  • Please provide the specific methods being used in the activity.
  • Provide at least three outcomes or objectives that are included in the activity brochure. What will the outcome be as a result of participation in this activity? Objectives should realistically state what the participant can learn in the activity. Use words such as “list’ identify, describe, compare, explain,” to describe what the participant will be able to do upon completion of the activity.
  • Provide details on the outline/agenda of the activity which develops the above objectives. Include introductions, breaks, meals and non-CE content time. Time spent evaluating the learning activity may be included in the contact minutes when calculating contact hours.
    Time Allotment (in minutes)Session TitleSpeaker Name and CredentialsContent (Topics) 
  • Please provide details on what other teaching methods are to be used in this activity.
  • Please provide the other learner engagement strategies to be used.
  • #1#2#3
  • Speaker Information

  • Upload a CV for each activity speaker.
    Drop files here or
    Accepted file types: pdf, doc, docx, Max. file size: 800 MB, Max. files: 5.
    • It is the policy of the ICEA to make best efforts to insure balance, independence, objectivity, and scientific rigor in all programs which qualify for Contact Hours. Consequently, all speakers/presenters participating in any program for which Contact Hours are awarded are expected to disclose to the program audience any affiliations that may have a bearing on the subject matter of their presentation. The intent of this policy is to ensure that any real or potential conflict of interest shall be identified openly so that listeners may form their own judgments about the presentation with the full disclosure of pertinent facts. It remains for the audience to determine whether the speaker’s outside interests may reflect a possible bias in the information presented.
    • Application Review Fee & Submission Process

      Upon submitting this application, the primary contact indicated above will receive an email with further instructions on collecting Speaker Disclosures & Conflict of Interest Declarations. Once the application has been reviewed and all of the speaker forms have been submitted, the primary contact will be provided with instructions on submitting payment for the awarded ICEA contact hours.

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    The International Childbirth Education Association (ICEA) is a professional organization that supports educators and health care professionals who believe in freedom to make decisions based on knowledge of alternatives in family-centered maternity and newborn care.

    ©2017 ICEA
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