APPENDIX 1
APPLICATION FOR ACCREDITATION OF A PROFESSIONAL DEVELOPMENT ACTIVITY
The course provider must send the following documents via e-mail to the Chambre de la sécurité financière
(CSF) or to the Institut québécois de planification financière (IQPF) for every course targeted by the
accreditation application:


This form and its appendices, once duly filled out
The instructors’ career resume
If you wish to fill out a common form for the CSF and the IQPF:
 Check both organizations in the "Application filed with" field
 E-mail all required documents to the CSF and the IQFP.
E-mail address for the CSF: accreditation@chambresf.com
E-mail address for the IQPF: accreditation@iqpf.org
Application filed with:
CSF
IQPF
If the activity has been accredited in the past, please state former number:
Former CSF accreditation number:
CSF - Former IQFP accreditation number:
IQPF - COURSE PROVIDER IDENTIFICATION
Name of course provider :
Address:
City:
Province:
Postal code:
Telephone number:
Fax number:
E-mail address:
Website address:
ACC-A-011-ang
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TYPE OF ORGANIZATION:
Training organization
Independent course provider (individual)
Educational institution recognized by the ministère de l’Éducation, du Loisir et du Sport du Québec
(MÉQ) (university, Cegep or other)
Company in insurance of persons
Company in group insurance of persons
Mutual fund dealer
Scholarship plans dealer
Firm in financial planning
Others, specify:
Contact information
Mrs.
Mr.
First name:
Last name:
Address (if different from that of the
course provider):
City:
Province:
Postal code:
Telephone number:
Fax number:
E-mail address:
IDENTIFICATION OF THE TRAINER(S)
To be filled out for as many trainers as applicable (attach a document to the application if there is more
than one trainer)
Name of trainer:
Company or organization:
Adress (if different from that of the
course provider):
City:
Province:
Postal code:
Telephone number:
Fax number:
E-mail address:
Website address:
Career resume:
Attach the trainer’s career resume to the application
For applications filed with the IQPF,
Yes
No
please specify whether your trainer is
a financial planner:
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By completing this section, you confirm that the instructor chosen to offer the training activity for which
you are applying for recognition has:
 The related knowledge
 The required experience
 The capacity to transmit the knowledge
Name:
Date:
I understand that selecting this check box constitutes my legally binding signature.
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IDENTIFICATION OF THE PROFESSIONAL DEVELOPMENT ACTIVITY
Activity title in French:
Activity title in English:
When would you like the accreditation of
your training activity to start (yyyy-mm-dd):
Your training activity is offered in:
French
English
Yes
No
Has your course been accredited or will it be
accredited with other organizations?
If so, which ones?
To be filled out only for accreditation applications with the CSF
Is the training activity being offered:
once?
several times?
Is this training activity only offered to people
Yes
No
who are part of your organization?
Sections where the activity is being
offered?
All
Laval
Eastern Abitibi
Manicouagan
Lower St. Lawrence, Gaspé Peninsula
Montreal
and Magdalen Islands
Outaouais
Beauce-Amiante
Québec
Drummond-Athabaska
Richelieu-Longueuil
Duplessis
Rivière-du-Loup
Eastern Townships
Rouyn-Noranda
Grande-Mauricie
Saguenay-Lac-Saint-Jean
Haute-Yamaska
Southwestern Quebec
Lanaudière
Laurentians
Is there a registration fee?
Yes
No
If so, how much?
$
Brief description of the training activity:
Would you like the training to be listed on
Yes
No
the CSF’s website?
Would you like the training to be listed on
Yes
No
the IQPF’s website?
If so, please supply us with a brief description thereof. If your activity is bilingual, you must also provide
us with an English version.
Description of the activity in French:
Description of the activity in English:
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Type of activity:
Classroom course
Symposium, lecture, convention
Distance education course
Webinar
Videoconference
Target audience:
Life and health insurance representatives
Group life and health insurance representatives
Group savings brokerage firm representatives
Scholarship plan brokerage firm representatives
Financial planners
Difficulty level:
Beginner
Intermediate
Advanced
TARGETED SUBJECT(S) FOR THE CSF
Check the subject(s) addressed in your training activity.
1. General subjects
Management of a financial services firm
Civil Code
Accounting
Economics
Finance
Business planning for clients
Business planning for representatives
Financial planning
Tax planning
Actuarial science
Legal environment
Intestate and testamentary successions
2. Insurance of persons
Client counselling
Underwriting or risk management
Disability insurance
Life insurance
Trusts
Risk management in insurance of persons
Underwriting in insurance of persons
Accident or health insurance plans
Segregated funds
Strategy of wealth accumulation and use
Financial needs analysis
Deferred income plan
Investor profiles and asset allocation
Investment strategy
Retirement and estate planning
3. Group insurance of persons
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Client counselling
Underwriting or risk management
Disability insurance
Life insurance
Group insurance and group pension plans
Benefits and underwriting in group insurance and group annuity plans
Setting up a group insurance and group annuity program
Preparing a rate schedule and analyzing group insurance and group annuity quotes
Preparing a group insurance and group annuity recommendation
Public and private plans
Processing group insurance claims
4. Group savings brokerage
Client counselling
Underwriting or risk management
Retirement and estate planning
Trusts
Strategy of wealth accumulation and use
Deferred income plan
Mutual funds
Investor profile and asset allocation
Investment strategy
Knowing the client
Registered plans
5. Scholarship plans
Client counselling
Underwriting or risk management
Investor profile
Knowing the client
Strategy of wealth accumulation and use
Scholarship plans
6. Compliance with standards, ethics and business conduct
Her is a non-exhaustive list, for information purposes only, of subjects that can be placed in this
category:
Notions of ethics, code of conduct and professional ethics
Code of ethics of the Chambre/ Regulation respecting the rules of ethics in the securities sector
Disciplinary committee’s jurisprudence
Role of the syndic and investigation process
Role of the disciplinary committee and disciplinary process
Compliance notions and program
Legal and regulatory obligations of registrants
Legal and regulatory obligations of representatives
Laws and regulations concerning the practice of registrants and representatives
Others:
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TARGETED SUBJECTS FOR THE IQPF
Legal aspects
Insurance
Finance
Taxation
Investment
Retirement
Successions
Training in compliance with standards, ethics and professional practice (SC)
Training in compliance with standards, ethics and professional practice related specifically to
financial planning (SC-FP)
COMPLETE ACTIVITY DESCRIPTION
1. Knowledge, competencies and professional skills
Identify the knowledge, competencies and professional skills that are expected to be developed via
the activity and briefly explain how the said activity will help develop the said knowledge,
competencies and skills (reference to the Regulation respecting the Professional Development of
Financial Planners – Section 18 for the CSF and Section 16 for the IQPF).
2. Method of assessment:
In case of a distance training activity, describe the summative assessment and the required result
that will confirm the participant’s success.
3. Course outline:
Fill out the attached course outline (Appendix 1A) by listing every topic and subtopic addressed, as
well as the time breakdown for each and the objective(s) related to the topic. You may also create
your own course outline with the same information.
REQUESTED ACCREDITATION
Total activity duration (minimum 1 hr):
Number of professional development units (PDUs) requested:
CSF subjects
hr
Number of
hours
Number
of PDUs
Total
Number of
hours
Number
of PDUs
General subjects
Insurance of persons
Group insurance of persons
Group savings plan brokerage
Scholarship plan brokerage
Compliance with standards, ethics and business conduct
IQPF subjects
SFPA
SC
7
SC-FP
Total
TO BE COMPLETED ONLY FOR A REQUEST FOR RECOGNITION FROM THE IQPF
This course contains information that promotes specific financial products or services.
Yes. How many hours or minutes?
No
Statement
I,
, confirm that all the information supplied in the present form is true and that I agree to every
condition respecting training activity accreditation.
I,
, have read the provider’s duties and obligations attached to the accreditation application and I
agree to comply with the said duties and obligations.
Date:
I understand that checking this box constitutes my legally binding signature.
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APPENDIX 1A: TRAINING PLAN
Fill out this training plan by listing every topic and subtopic addressed, as well as the time breakdown for each and the objective(s) related to the
topic. You may also create your own course outline with the same information.
Activity title:
General objective:
At the end of the training activity,
the participant will be able to…
Specific objectives
States what the
participant will be able to
do at the end of the
training activity. Contains
a verb of action
describing an observable
behavior
Elements of content
Topics addressed by the
training activity with
respect to the specific
objective
Learning strategy
E.g.: lecture, practical
exercises, group
discussion, team
workshop, case studies,
etc.
Teaching
material
E.g.: PowerPoint,
textbook, tools,
exercise book,
etc.
Duration
For each
objective
Subjects*
CSF
IQPF
CSF
IQPF
CSF
IQPF
CSF
IQPF
CSF
IQPF
CSF
IQPF
CSF
IQPF
CSF
IQPF
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CSF
IQPF
CSF
IQPF
*Subject list and abbreviations:
CSF
GLHI: Group life and health insurance; LHI: Life and health insurance; GSB: Group savings brokerage; CO: Compliance; SPB: Scholarship plan brokerage; GS: General subjects
IQPF
SC: Training in compliance with standards, ethics and professional practice, SC-FP: Training in compliance with standards, ethics and professional practice related specifically to
financial planning; SFPA: Law, insurance, finance, taxation, investment, retirement and successions
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APPENDIX 2A: CREDIT CARD AUTHORIZATION FOR THE CSF – QUEBEC
I hereby authorize the Chambre de la sécurité financière to charge $
, representing the fees
described below respecting the following training activity on the credit card account appearing
hereunder:
Activity title:
Name of course provider:
CREDIT CARD
Visa
MasterCard
Credit card number:
Expiry date (yyyy-mm):
Cardholder:
I understand that checking this box constitutes my legally binding signature.
AMOUNT DESCRIPTION
This amount covers the following charges:
Activity accreditation:
Activity offered once
Activity offered several times
Basic fee of $344.93 ($300.00 plus $15.00 (5% GST) and
$29.93 (9.975% QST))
Additional fee of $68.99 for every hour exceeding 5 hours
($60.00 plus $3.00 (5% GST) and $5.99 (9.975% QST))
Basic fee of $408.16 ($355.00 plus $17.75 (5% GST) and
$35.41 (9.975% QST))
Additional fee of $81.63 for every hour exceeding 5 hours
($71.00 plus $3.55 (5% GST) and $7.08 (9.975% QST))
Federal tax: 875755423 RT
Provincial tax: 1022122980
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APPENDIX 2B: CREDIT CARD AUTHORIZATION FOR THE CSF – ONTARIO
I hereby authorize the Chambre de la sécurité financière to charge $
, representing the fees
described below respecting the following training activity on the credit card account appearing
hereunder:
Activity title:
Name of course provider:
CREDIT CARD
Visa
MasterCard
Credit card number:
Expiry date (yyyy-mm):
Cardholder:
I understand that checking this box constitutes my legally binding signature.
AMOUNT DESCRIPTION
This amount covers the following charges:
Activity accreditation
Activity offered once
Activity offered several times
Basic fee of $339.00 ($300.00 plus $39.00 (13% HST))
Additional fee of $67.80 for every hour exceeding 5 hours
($60.00 plus $7.80 (13% HST))
Basic fee of $401.15 ($355.00 plus $46.15 (13% HST))
Additional fee of $80.23 for every hour exceeding 5 hours
($71.00 plus $9.23 (13% HST))
Federal tax: 875755423 RT
Provincial tax: 1022122980
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APPENDIX 2C: CREDIT CARD AUTHORIZATION FOR THE CSF – MANITOBA
I hereby authorize the Chambre de la sécurité financière to charge $
, representing the fees
described below respecting the following training activity on the credit card account appearing
hereunder:
Activity title:
Name of course provider:
CREDIT CARD
Visa
MasterCard
Credit card number:
Expiry date (yyyy-mm):
Cardholder:
I understand that checking this box constitutes my legally binding signature.
AMOUNT DESCRIPTION
This amount covers the following charges:
Activity accreditation:
Activity offered once
Activity offered several times
Basic fee of $339.00 ($300.00 plus $15.00 (5% GST) and
$24.00 (8% RST))
Additional fee of $67.80 for every hour exceeding 5 hours
($60.00 plus $3.00 (5% GST) and $4.80 (8% RST))
Basic fee of $401.15 ($355.00 plus $17.75 (5% GST) and
$28.40 (8% RST))
Additional fee of $80.23 for every hour exceeding 5 hours
($71.00 plus $3.55 (5% GST) and $5.68 (8% RST))
Federal tax: 875755423 RT
Provincial tax: 1022122980
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ANNEXE 2D: CREDIT CARD AUTHORIZATION FOR THE IQPF
ACCREDITATION FEES

A $258.69* fee (taxes included) is charged to open and analyse a file for each course accreditation
application received by the IQPF. This amount is not refundable.

A $229.95* fee (taxes included) is charged for the attribution of one to six PDUs.

An additional $74.73* fee (taxes included) is to be charged for every additional PDU.
Method of payment
Visa
Amount:
Master Card
American Express
$
Credit card number:
Expiry date (yyyy-mm):
Security Code (3 or 4 numbers)
Cardholder’s name:
I understand that checking this box constitutes my legally binding signature.
I will send a cheque to the Institut québécois de planification financière
(write the course title on the cheque)
Other; please specify:
Federal tax: 128798345
Provincial tax: 1012743811TQ0001
*Rates subject to change without notice.
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