Course Assessment - Submission Form

The First Step...

To have your Course assessed by ANTA complete the form below.

* denotes required field

Institution Details
Course Provider Name:	*
ACN:	*
Address:	*
State:	*
Postcode:	*
Phone No:	*
Fax No:
Email:	*
Website:
Contact Person
Full Name:	*
Position/Title:	*
Course Information
Course Title/Name:	*
Qualification:	*	(ie Diploma, Advanced Diploma, Degree)
Health Training Package Code:		HLT (if applicable)
RTO No:		(if applicable)
RTO Expiry Date:		(dd/mm/yyyy)
Course Delivery Mode:	*	(ie on campus or other)
Note: ANTA, Health Funds & WorkCover do not recognise Courses delivered substantially online or by distance education modes.
Length of course in years:	*	(full time study)
Total Course Hours
Student on campus:	*	HRS
Required attendance rate:	*	(%)
Student off Campus:	*	HRS
Student home study:	*	HRS
Clinic Hours:	*	HRS
Other (specify):		HRS
Total Course Hours:	*	HRS
Breakdown of Clinic Hours shown above:
Supervised clinic on campus:	*	HRS
Required attendance rate:	*	(%)
Supervised clinic off campus:	*	HRS
Non-supervised clinic:	*	HRS
Other clinic (specify):		HRS
Total Clinical Hours:	*	HRS
Name of authorised course provider representative:	*
		I declare I am a person authorised to certify the information provided on this Course Assessment submission document is correct and accurate and ANTA will be notified immediately if there are any changes or alterations to the course title, course delivery modes, length of course, course units, on campus hours, supervised clinic hours, total clinic hours and RTO status.
Position/Title:	*
Disclaimer:		ANTA reserves the right to suspend or withdraw course recognition.
Enter code as shown below:	*

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The Natural Therapist

Issue: 28 No. 1 | Mar, 2013

Advertise on ANTA's website today or in the Natural Therapist journal and reach out to Australia's growing Natural Therapies community.