Appendix G

Professional Regulation Commission

APPLICATION FOR ACCREDITATION OF CPD PROGRAM

CPD COUNCIL OF/FOR PROFESSIONAL TEACHER

Part I. General Information

Name of Provider: Department of Education Regional Office I

Accreditation No.: PTR -2021 - 324 Expiration Date: June 30, 2024

Contact Person: Dinah C. Bonao Designation: Chief Education Supervisor

Contact No.: 09985835730 Date of Application:

Email add.:
[email protected]/[email protected]

Proposed Program:

Conference Seminar Online Learning

Convention Workshop Educational/Study Tour

Title of the Program:

Date to be offered: Duration: Time:

Venue and Address: No. of times program to be conducted:

Course Description:

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Objectives:

Number of Target Participants: 80 Registration fee to be collected: None

Part II. Acknowledgment

I hereby certify that the above information written by me are true and correct to the best of my knowledge
and belief. I further authorize PRC and other agencies to investigate the authenticity of all the documents
presented.

I am agreeing to the PRC Privacy Notice and giving my consent to the collection and processing of my
personal data in accordance thereto.
_________________________________
(Signature Over Printed Name)

____________________________
Position

________________________
Date

Part III. Assessment

Regulation Division: Cash Division:

Assessed by : ___________________ Amount : ___________ O.R. No.: ____________

Date : ___________________ Date : ____________________

Remarks : ___________________ Issued by : ____________________

Part IV. Action taken by the CPD Council

Approved for _____ credit units Accreditation No. _______________

Deferred pending compliance ____________________________________

_ ___________________________________________________________

Disapproved due to ____________________________________________

____________________________________________________________

_____________________________

Chairperson

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 ____________________________ _____________________________

Member Member

Date:____________________

PROCEDURE FOR ACCREDITATION OF CPD PROGRAM

Step 1. Secure application form at Regulations Division of any of the PRC Regional Offices or download at

PRC website (www.prc.gov.ph).

Step 2. Fill-out Application Form and attach supporting documents listed hereunder. Provide one (1)

set for receiving copy.

Step 3. Proceed to Regulations Division of any of the PRC Regional Offices for checking and assessment.

Step 4. If the assessment is favorable, pay prescribed fee of One Thousand Pesos (₱ 1,000.00) per

program offering. Government agencies and instrumentalities offering CPD Programs free of

charge, do not have to pay a fee. If not favorable, go back to Step 3.

Step 5. Submit Application Form with attached supporting documents and photocopy of official receipt to

Regulations Division of any of the PRC Regional Offices, at least fifteen (15) working days prior to

offering.

Step 6. Follow-up the application ten (10) working days after submission at CPD Division (Central Office),

telephone numbers (+632) 8810-84-15 (PRC-PICC), or email at [email protected]

CHECKLIST OF REQUIREMENTS

Supporting Documents

[ ] Instructional Design as prescribed by the relevant Board.

[ ] Program of Activities showing time/duration of topics/workshop and resource persons with position

and office, and evaluation period.

[ ] Evaluation method or tool that measures the learning gained by the participants specific and

appropriate to course objectives set

[ ] Resume of resource persons relevant to CPD program applied for.

[ ] Photo copy of valid Professional Identification Card of resource persons if registered professional.

Otherwise, submit photocopy of government-issued or company Identification Card.

[ ] Valid Special Temporary Permit if the resource person is a foreigner and if engagement is more than

three (3) days or there is physical contact with patients in the case of medical and allied professions.

[ ] Breakdown of expenses for the conduct of the CPD program.

[ ] For Online Learning, Declaration of Minimum Technical Requirements (e.g. Operating System,

Processor, Memory, Browser, Internet Connection, etc.)

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 Additional Requirements

[ ] Short brown envelope for the Certificate of Accreditation

[ ] One (1) set of metered documentary stamps worth Twenty-Five Pesos (₱ 25.00) each to be affixed to

the Certificate of Accreditation. (Available at PRC Customer Service and PRC Regional Offices)

[ ] Soft copy of the Application including supporting attachments in PDF format saved in flash drive.

Note:

1. Application for accreditation should be filed 15 working days before the offering of the program/training.
2. Representative/s filing application/s for accreditation and claiming the Certificate of Accreditation on
behalf of the applicant must present a letter of authorization and valid identification cards of both the
authorized signatory and the representative. In the case of national organizations with chapters/councils,
endorsement from the national board.
3. The period for processing the application is 10 working days, subject to the stipulations in these
guidelines.
4. If additional requirement/s is/are needed, a period of another 10 working days is given to submit the
same. Failure to comply within the period shall be construed as abandonment of application and the
prescribed fee shall be forfeited in favor of the government.
5. The CPD Council shall have the right to specify additional requirements if deemed necessary and
appropriate.

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