2014-15 CPD Audit Form

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Continuing Professional Development
Audit Form 2014/15
Write clearly using CAPITAL LETTERS and tick boxes where applicable
Family Name:
First Name(s):
Membership ID:
Country:
If you have been awarded a part exemption please specify the number of CPD hours you have to complete _____
Section 1
Option 1: Provide details for each CPD activity that you have participated in. The total hours should equal the minimum requirement of 24 hours
(unless you have been awarded a part exemption); up to 8 hours of this can be Independent CPD. Details should include dates, title of activity, type of
evidence provided and number of hours or credits associated with it, see overleaf for further information. Continue on a separate sheet of paper if
necessary and REMEMBER to send copies of your supporting evidence with this form.
Date of Activity
From
CPD Activity
To
Evidence Provided (Please note you
are not required to provide for
Independent CPD activities)
Hours/Credits
Internal Use
Total hours:
Date of Activity
From
Independent CPD Activity
To
Hours (2 hr’s
maximum per
activity)
Internal Use
Total hours:
Option 2: I will share my profile on the ePortfolio where you will find documents uploaded as evidence of my CPD activity for the period of 1 July
2014 to 30 June 2015  (please tick)
(Please contact the CPD department at cpd@rad.org.uk for further information on how to share your information via the ePortfolio)
Section 2
I confirm that the information I have given in this form is true and accurate to the best of my knowledge. I understand that submission of a false form is a
breach of the Code of Professional Practice for teachers registered with the Royal Academy of Dance. By signing you are also declaring completion or
non-completion of your CPD requirement for the 2014/15 year (if you have not yet submitted a declaration).
Signature:
Date:
Send to
Send this form directly to your national office. See the accompanying list of national offices for contact details. If you do not have a
national office in your country, send this application to the United Kingdom.
Internal Use Only
Staff Initials:
Date Received:
Date Processed:
Outcome:
Version 2, June 2015
Royal Academy of Dance® is a Charity Registered in England & Wales No. 312826
Continuing Professional Development Audit Form - Instructions and Guidance
The 2014/15 Continuing Professional Development year runs from 1 July 2014 to 30 June 2015. As part of the 2014/15 audit of your CPD
activity, you must complete this form or the version available to download at www.rad.org.uk/cpdaudit and return it with supporting evidence.
We will not be able to complete the audit of your activity without this form:
Completing Section 1
Select either:
Option 1; return this form with accompanying evidence to CPD department.
Option 2 return this form and share your evidence with the Academy via your profile on the ePortfolio.
Please contact the CPD department at cpd@rad.org.uk for further information on how to share your evidence via the ePortfolio.
For both options you must evidence that you have met the minimum requirement of 24 hours of CPD or your remaining requirement if you
received a part-exemption.
For each activity that you have participated in, please include a copy of one piece of evidence only. Please note, we do not need evidence of
more than 24 hours of CPD.
All evidence must show:
1. Your name
2. The date (or range of dates) of the activities
3. Title of the activities
4. Confirmation of your attendance/participation in the activities
Any evidence you include with the Audit Form must clearly verify your attendance/participation in the activity.
Examples of evidence include but are not restricted to:
• copies of certificates
• letters of attendance
Independent CPD:
A maximum of 8 hours may be completed by participating in Independent CPD; each Independent CPD activity must be no more than 2 hours.
As it is difficult to evidence Independent CPD, we do not require you to provide evidence of this. If however, for any reason we require
clarification on a specified Independent CPD activity we reserve the right to ask you to provide further information.
Please do not send original documents, as we cannot return them to you unless you provide a self- addressed stamped
envelope.
Completing Section 2
You must sign and date the form to confirm the information you have given is true and accurate to the best of your knowledge. Submission of
a false form is a breach of the Code of Professional Practice for teachers registered with the Royal Academy of Dance.
What happens when we receive your form?

We will send you an email confirming receipt of your audit data.

We will review the information you have sent us.

If we need any further clarification or information regarding your evidence we will contact you either via email or telephone.

Once we have reviewed the information you have sent us we will contact you to confirm whether you have successfully completed
your CPD requirement for the 2014/15 CPD year.

If after further consultation with you, you have been unable to demonstrate that you have met the minimum CPD requirement we
will send confirmation that you have not completed your CPD requirement for the 2014/15 CPD year and explain what will happen
next.
Questions
If you have questions about the CPD audit please contact your national office. See the accompanying list of national offices for contact details.
If you do not have a national office listed for your country, contact the United Kingdom.
Version 2, June 2015
Royal Academy of Dance® is a Charity Registered in England & Wales No. 312826
National Offices
AUSTRALIA & PAPUA NEW
GUINEA
Royal Academy of Dance
20 Farrell Avenue
Darlinghurst NSW 2010
Australia
t: (61) 2 9331 4111
f: (61) 2 9360 6677
info@rad.org.au
www.rad.org.au
BENELUX & FRANCE
Jacqueline Spence
Royal Academy of Dance asbl
21 Cité Joseph Bech
L-6186 Gonderange
Luxembourg
t: (352) 787225
f: (352) 787217
RAD-Benelux@pt.lu
RAD-France@pt.lu
www.rad.lu
CHINA
Professor Ting Tina Chen
2nd Floor Tower 2
Dong Hai Commercial Building
588 Yan An Dong Lu
Shanghai China
Tel: (86) 21 6597 6399
Fax: (86) 21 6513 7188
email: radchina@hotmail.com
Chief Representative: Tel: 86 21 6598
9068
leendtina@gmail.com
CYPRUS
Mr George Shantos
19 Vassa Kilaniou
4771 Limassol
Cyprus
t: (357) 99 477 887
f: (357) 24 818 351
info@rad.com.cy
www.rad.com.cy
BRAZIL, PERU, ECUADOR &
CHILE
Maria do Carmo de Kenny
Royal Academy of Dance Brasil Ltda.
R Dr Francisco A Tozzi, 180
Estância Suiça
13930 000 Serra Negra-SP
Brasil
t/f: (55) 19 3892 3985
mckenny@royalacademyofdance.com.br
www.royalacademyofdance.com.br
GERMANY, AUSTRIA and
SWITZERLAND
Horst Vollmer
Royal Academy of Dance gGmbH
Waldenserstr 2-4
10551 Berlin
Germany
t: +49 (0)30 39 40 466 60
f: +49 (0)30 39 40 466 69
info@royalacademyofdance.de
www.royalacademyofdance.de
CANADA
Royal Academy of Dance
Suite 601, 1210 Sheppard Avenue E
Toronto, Ontario
M2K 1E3
Canada
t: (1) 416 489 2813
f: (1) 416 489 3222
info@radcanada.org
www.radcanada.org
GREECE
Veta Anastasopoulou
The British Council
17 Kolonaki Square
Athens 10673
Greece
t: (30) 210 364 3691
f: (30) 210 363 0332
rad@britishcouncil.gr
CARIBBEAN
(Jamaica, Dominican Republic, Bahamas,
Trinidad and Tobago, Barbados, St Lucia
and Antigua)
Diane C Bernard
Royal Academy of Dance
PO Box 1433
8 Rockhampton Drive
Kingston 8
Jamaica
t/f: (001) 876 755 0612
dianebernard@rad.org.jm
Version 2, June 2015
HONG KONG
Hong Kong Examinations & Assessment
Authority
International and Professional
Examinations Division
17 Tseuk Luk Street
San Po King, Kowloon
Hong Kong
t: (852) 3628 8761
f: (852) 3628 8790
ie7@hkeaa.edu.hk
INDONESIA
Lala Salendu
Yayasan Royal Academy of Dance
Indonesia
Jl.Angur III no: 1 Cipete
Jakarta Selatan 12410
Indonesia
t: (62) 21 75 90 93 63
f: (62) 21 75 90 93 70
radindonesia@cbn.net.id
REPUBLIC OF IRELAND
Beverley Dinsmore
Royal Academy of Dance
Holly Lodge
Pidgeon House Lane
Julianstown
Co. Meath
Ireland
t: (353) 419 811 915
bdinsmore@rad.ie
ISRAEL
Gali Zamir
Royal Academy of Dance
Hadar Str. 491
Neve Yamin
Israel.
t: (972) 52 3343 838
gali@rad.org.il
ITALY
Manuela de Luca
Royal Academy of Dance Srl
Via Vannetti 12
38122 Trento
Italy
t: (39) 0461 985 055
f: (39) 0461 985 054
info@raditaly.it
www.raditaly.it
JAPAN
Noriko Kobayashi
Royal Academy of Dance
Commerce Building 5F
2-39-3 Mejiro
Toshima-Ku Tokyo 171-0031
Japan
t: (81) 3 3987 3750
f: (81) 3 3987 3649
radjapan@nifty.com
MALAYSIA
Zafriah Ahmad
RAD Dancing (Malaysia) Sdn Bhd
43 Jalan BU 7/ 7
Bandar Utama
47800 Petaling Jaya
Selangor
Malaysia
t: (60) 3 6259 4641
radmalaysia@gmail.com
MALTA
Sandra Mifsud
8 Guze Ellul Mercer Street
Sliema
Malta
SLM1281
t: (356) 7993 8584
info@radmalta.org
www.radrmalta.org
Royal Academy of Dance® is a Charity Registered in England & Wales No. 312826
MEXICO, EL SALVADOR,
HONDURAS, COSTA RICA,
GUATEMALA, PANAMA
Julieta Navarro
Royal Academy of Dance de Mexico AC
Amates 18, Fracc alconfores
San Mateo, Naucalpan CP
53240, Mexico
t: (52) 55 5360 2700
f: (52) 55 5373 4069
radmexju@prodigy.net.mx
NEW ZEALAND
Royal Academy of Dance
Level 5 Outwide House,
61-63 Taranaki Street,
Wellington 6011
New Zealand
t: (64) 4 382 8924
f: (64) 4 382 8200
info@rad.org.nz
www.rad.org.nz
info@rad.org.nz
www.rad.org.nz
SOUTH KOREA
Hyun Joo Ham
# 1703 Artnouveau Palace
7-1 Songpa Dong
Songpa Gu
Seoul 138-848
Korea
t/f: (82) 2 532 1910
hjham@radkorea.org
www.radkorea.org
SPAIN, GIBRALTAR & ANDORRA
Maria José Antón
Royal Academy of Dance SL
Ventura i Gassol 3, 5è-3a
43203 Reus,Tarragona
Spain
t: (34) 977 34 24 89
t/f: (34) 977 34 19 35
info@rad.org.es
www.rad.org.es
NORWAY, SWEDEN &
DENMARK
Karina Lund
Smedstuveien 25
7040 Trondheim
Norway
t: (47) 979 592 0812
klund@royalacademyofdance.no
www.royalacademyofdance.no
PHILIPPINES
Lauren Ann Pascua
Examinations Services Officer
The British Council
10F Taipan Building
F Ortigas Jr. Road,
Ortigas Centre
Pasig City 1605
Philippines
t: +63 (2) 5553041 ext 141
f: +63 (2) 5553080 or +63 (2) 5553090
lauren.pascua@britishcouncil.org.ph
PORTUGAL
Margarida Sa Fialho
Royal Academy of Dance
Rua 4 Infantaria 86
1350-241 Lisboa
Portugal
t/f: (351) 21 383 1849
radportugal@rad.org.pt
SINGAPORE
Mona Lim
Royal Academy of Dance Singapore
Pte Ltd, Farrer Road Post Office
PO Box 106
Singapore 912804
t: (65) 6762 8993
f: (65) 6762 4031
mona.lim@rad.sg
www.rad.sg
Version 2, June 2015
SOUTH AFRICA, BOTSWANA,
KENYA, MAURITIUS,
MOZAMBIQUE, NAMIBIA,
SWAZILAND & ZIMBABWE
Royal Academy of Dance
PO Box 200, Bramley 2018
Johannesburg
South Africa
t: (27) 11 887 0459
f: (27) 11 887 0561
info@rad.org.za
www.rad.org.za
SOUTH ASIA
Ranmali Mirchandani
40A, Lake Gardens
Off Lake Drive
Rajagiriya 10100
Sri Lanka
t: (94) 777 349399
radsouthasia@gmail.com
TAIWAN
Shu-Yu Lin
5F, No 122, Sect 7
Chung Shan N. Road
Taipei 11151
Taiwan
t: (886) 22 871 5615
f: (886) 22 874 7783
linshuyu82@hotmail.com
www.rad.org.tw
TURKEY
Merve Kalyoncu
The British Council
Maya Akar Centre
No 100 - 101 Buyudere Cad
Esentepe 80280
Istanbul
Turkey
t: (90) (0)212 355 5657
f: (90) (0)212 355 5659
merve.kalyoncu@britishcouncil.org.tr
UNITED ARAB EMIRATES,
BAHRAIN, QATAR & OMAN
Shabnam Habib
Examinations Services Manager
The British Council
PO Box 1636
Dubai
U.A.E.
t: 971 (0)4 3135568
m: 971 (0)4 3370703
f: (971) 4 3370703
shabnam.habib@ae.britishcouncil.org
www.britishcouncil.org/uae
UNITED STATES OF AMERICA
Royal Academy of Dance
Marian Center for Non-profits
3211 South Lake Drive, Suite R317
St Francis 53235
Wisconsin
USA
t: 00 1 414 747 9060
f: 00 1 414 747 9062
info@radusa.org
www.radusa.org
UNITED KINGDOM
Membership Officer (CPD)
The Membership Department
Royal Academy of Dance
36 Battersea Square
London
SW11 3RA
UK
t: 44 (0) 20 7326 8022
f: 44 (0) 20 7924 3129
membership@rad.org.uk
www.rad.org.uk
THAILAND
Glenn van der Hoff
RAD Dancing (Thailand) Co.Ltd
121/12, Moo 10, Changmai-Hangdong
Road
Tambon: Pae Dad
Ampur: Muang
Chiang Mai 50100
Thailand
t/f: (66) 0 5327 4841
m: (66) 08 515 64 562 (office hours)
radthailandglenn@gmail.com
www.radthailand.org
Royal Academy of Dance® is a Charity Registered in England & Wales No. 312826
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