About

Speaker, Individual Workshop or Conference Session Application! The Alliance board is open to all relevant subjects but we suggest that applications exhibit dynamics that are geared towards professional and public enthusiasm for high consideration.

Workshop Title:

Workshop Overview (please provide a summary or abstract of your workshop…150 words or less)

List all workshop Instructor(s), along with degree(s) & license number(s):

Are you already certified to give CEs (continuing education credits)? This is not a must, but say yes or no.

Which Licensing agency(ies) & which state(s), or if not what are your other qualifications?:

State yes or no for at least one of the three criteria below of the presenter/instructor to qualify to offer the CE: 1. Faculty member of accredited undergraduate or graduate school of social work (or counseling, psychology),

2. Have specialized graduate or postgraduate training in the subject being taught,

3. Have extensive experience including no less than five years of practical application or research in the subject? OR I am not applying for CE for my workshop.

Date preference? (Friday or Saturday; Enter zero if no preference):

Describe Workshop Target Audience:

State workshop Content Level: Beginner: Intermediate: Advanced:

Workshop Description (describe what and how you will conduct the workshop, materials used)

IF TARGETING FAITH-BASED ATTENDEES, Please describe how you plan to integrate Biblical faith:

List 3 Measurable Learning Objectives (see the Acceptable learning objectives list at www.aswb.org/wp-content/uploads/2018/09/ACE-Handbook-Acceptable-learning-objectives-list.pdf)

List your references, at least 3 peer-reviewed articles/research, used in this presentation (At least 50 percent of your references must be current within the past 5 years, and a maximum of 5 current references total). For questions, please review page 1

Workshop Content & Credit: Acceptable content areas for CE credit:

Theories & concepts of human behavior & social environment Social work, knowledge, & skills Social work research, program evaluation or practice evaluation Management, administration, or social policy Social work ethics including but not limited to......

....Topics in boundaries relationship, conflicts of interest, confidentiality & record-keeping

Workshop length: 1hr (1.0 CE) or 1hr 30min (1.5 CE)

State type of credit to be granted (state one): Clinical social/therapy work Cultural competency N/A Ethics General social work

Upon approval of this workshop, will it be offered to licensed health professionals in other states?

Is the content free of commercial bias? (Cannot promote, offer, or sell specific products or services in the context of a learning activity)

Does your content infringe on copyright laws?

Attachments & Documentation: The items listed below must be included as attachments to your individual workshop application via same email.

1. Biography of the presenter (1 paragraph here or upload as an attachment) 2. Instructor(s) resumes/curriculum vitae 3. Workshop materials (handouts, power points, articles via email attachments). If not available now, email them ASAP please.

Hit the Submit button below...BUT, EMAIL ALL REQUIRED ATTACHMENTS 1, 2, & 3 to info@therapeuticchoice.com. (Questions?…same email) DEADLINE SUBMISSION IS JUNE 30! The Alliance will inform you of acceptance by 1st week of July.

This is your About Page. It's a great opportunity to give a full background on who you are, what you do and what your website has to offer. Double click on the text box to start editing your content and make sure to add all the relevant details you want to share with site visitors.