Event Name: Event Organiser: Event CPD Reference Number: Event Date: If you did not attend any of these sessions, Please cross the line out. Sessions within the Event: Start Time End Session Name Presenter(s) Hours Credits Office – Time attended Use Only Total Hours Total Credits OPTOMETRIST’S NAME: NZAO Number Registration Number: (if applicable): Email Address: SIGNED: DATE: …………………………………………………… …………………………..
Event Name: Event Organiser: Event CPD Reference Number: Event Date: If you did not attend any of these sessions, Please cross the line out. Sessions within the Event: Start Time – End Time Session Name Presenter(s) Hours attended Credits Office Use Only Total Hours Total Credits OPTOMETRIST’S NAME: NZAO Number (if applicable): Registration Number: Email Address: SIGNED: …………………………………………………… DATE: …………………………..
CPD-Application-Peer-Review-Sep-2018.docx