Submit Digital Forms

Recommended if applying to Liberia Board of Accreditation and Licensure of Medical Laboratory Technology (BALMLT)

    * Name of CPD Provider

    * Contact Person

    * Job Title of Contact Person

    * Phone Number of Contact Person

    * Email Address of Contact Person

    * Physical Address of Contact Person

    * Website

    If outside of Liberia, name of partner organization in Liberia

    * In which counties do you plan to provide CPD?

    * Which term best describes your organization?

    Other, please describe:

    Please submit the following along with your CPD Provider Registration Form:

    [Required] Business registration or equivalent documentation (e.g. Council of Higher Education accreditation, MOH Sectoral Clearance, articles of incorporation, etc.). For organizations outside of Liberia, include documentation for both the CPD provider and partner organization in Liberia.

    [Optional] Training plan, including course topics and description of target audience

    [Optional] For registration renewals, reports or evaluations from previously-delivered CPD courses