Application for ATF accreditation of an on site course or a live online seminar (without recording)
Please fill in the marked fields, only complete applications will be processed.
Applicant 
Company / Department

Name 
(title, first name, and surname)

Address:
(street, zip code, city, country)

Phone / e-mail (contact details)

Alternative invoice recipient
(billing address; only if necessary)

E-mail for invoice dispatch 
(electronic invoice; please only fill in if the invoice must be sent to an e-mail address other than the applicant's)

Your order number, cost center, etc. 
(Please enter here all information that must be included on the invoice; only if necessary)

Your VAT number
(only for invoice recipients outside Germany, e.g. ATU number for Austria)

Information about the course 
The following information is mandatory for checking whether the criteria according to § 10 of the ATF statutes and the executive information for ATF accreditation are met. 
Please fill in the marked fields and add attachments if necessary (e.g. program). 
Only complete applications will be processed.
Type of course (please tick): 

on-site course						

live online seminar (unrecorded)

hybrid event (unrecorded) 	

Type of accreditation (please tick): 

approved continuing education
non-veterinary professional skills
(formerly generic term "commercial-economic practice management")

Updating of the continuing education obligation 
in accordance with § 7 (2) SchHaltHygV 
(legal requirements for German veterinarians) 
Course title
(Please state the title used for publication and application)

Place / Location of the course (URL / website for live online seminars)

Date of the course

Program
Please insert the detailed program with topics and speakers as well as the complete schedule including start and end of the course as well as exact break times. Only with this information, it is possible to calculate the accreditable training time).

Speakers
(Please provide the following information about the speakers: Title, first and last name, veterinarian status. For non-veterinary speakers in particular, the following information is also required: information on profession, state-recognized professional qualification and any other information).

Organizer
(Please indicate name and address, if not simultaneously applicant)

Participants
(Please indicate the professional qualifications of the participants. Especially for non-veterinary participants, the following additional information is required: information about a completed, state-approved education, profession, further information, if applicable)

Participation options
(Please indicate whether participation is possible only in the entire event or also in individual parts. This information is mandatory for the appropriate calculation of the ATF hours.)

Public accessibility

Yes																							No

(What are the accessibility restrictions? Participation for members of an organization/association? Participation for people with previous knowledge? Participation for members of a practice/clinic/veterinary practice operator [e.g. AniCura, SmartVet, Evidensia etc.]? etc.)

Public announcement

Yes																							No

(Where is the event announced in media freely accessible to veterinarians [mandatory for ATF accreditation]? Please name the website [specify link] or magazine [specify title and issue]).

	I agree to the processing of my personal data for this application for ATF accreditation (please mark with a cross; see Data protection information)	

Place, Date		Signature	

Please send your application via e-mail to atf@btkberlin.de.