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NBC Course Approval Request Form
Please complete one form per course approval request. Approvals will be granted and emailed within 30 days of submission. When courses must be approved within 10 business days, a rush fee will be added as outlined below.
NBC Approved Courses will be listed in the Continuing Education Provider Directory: a collaborative project between the Foundation for Dental Laboratory Technology and NBC, found at www.dentallabfoundation.org/CESearch.
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I. General Information
Please provide speaker/course provider information.
Speaker Name
*
Prefix
First
MI
Last
Suffix
NOTE: if group or panel course, will be documented under first name listed
Professional Designation
*
Select Credential
CDT
RG
DDS
DMD
MD/DO
Other
N/A
Speakers who are credentialed in dental technology or dentistry (those who hold a CDT, DDS, other equivalent international accreditation or applicable formal education) will be approved for Regulatory Standards or Scientific courses when course content is appropriate. If the speaker is not credentialed, the course will be approved for Professional Development credit. When course content is not scientific in nature, it will be approved for Professional Development credit regardless of speaker credential.
(please attach bio.CV for first time approval)
Speaker CDT/RG #
(if applicable, ex. 000000-00)
Speaker Email
Speaker Contact Number
###
-
###
-
####
Speaker a member of NADL?
Yes
No
Additional Speaker 1
(if applicable)
Additional Speaker 2
(if applicable)
Course Provider/Sponsoring Organization
*
(if applicable)
II. Course Information
If the program will be presented by the same speaker multiple times in a given year, multi-date approval will be granted.
Course Title
*
(limited to 75 characters)
Credit Hours
*
(hour per hour basis)
Program Date for Single-Date Course
MM
/
DD
/
YYYY
(only enter date for single-date course)
Program Year
*
Brief Program Description
(attach outline or syllabus if preferred)
Please provide a link to your online course, if applicable/available
Course Outline
(if applicable)
Type of Credit
Regulatory Standards
Scientific
Professional Development
(select one)
NBC will determine the type of credit based on course content and speaker credential. Approval documents will indicate type of course. Abbreviated description for Type of credit follows. Content for Regulatory Standards courses: Infection Control, OSHA, HIPAA, FDA Regulations, Emergency Actions plans, etc. Content for Scientific courses: anything pertaining to the dental technology field. Content for Professional Development courses: Marketing, Business skills, Communication skills, etc. Additional information is located at http://nbccert.org/education/.
Complete Dentures
YES
NO
Partial Dentures
YES
NO
Crown & Bridge
YES
NO
Ceramics
YES
NO
Orthodontics
YES
NO
Implants
YES
NO
CAD/CAM
YES
NO
(required to be searchable online)
Delivery Method
*
Live Webinar
Online Course
In Person Seminar
Magazine Article
Video
Textbook/Reference Material
Please note that webinars that will be presented live and then made available on demand will be approved as Multi-Date courses.
Educational Level of Course
Beginner
Intermediate
Advanced
Master
Prerequisite Knowledge
Yes
No
Learning Objectives
1
/
3
Total
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