FOR CE COMMITTEE Check Received ______ Date Approved __ ______ Number of Hrs Approved _____ Notification to Sponsor _____ __ NATIONAL ASSOCIATION OF SOCIAL WORKERS APPLICATION FOR SOCIAL WORK CONTINUING EDUCATION HOURS Date:_______________ _______ SPONSOR (Individual or agency) __ _____________________________________________________ ADDRESS: ______________ _______________________CITY: _____ STATE: ___ ZIP: _ _______ PHONE: __ __________ FAX:__ __________________ EMAIL: _ ______________________ CONTACT PERSON (if other than above): ______________________________________________ CONFERENCE OR TRAINING TITLE: __ ______________________________________________ DATE: _________ ______________________________________________________________ TIME: ____ ___________________________________________________________________ LOCATION: __ ________________________________________________________________ FEE(S): ______ ________________________________________________________________ Describe the specific course content and attach the time schedule and program agenda: List the learning objectives: ___________________________________________________________ ___________________________________________________________________________________ How will these objectives be measured? (Attach any evaluation instrument to be used) ________________ ___________________________________________________________________ Please attach a resume or curriculum vitae for EACH trainer or presenter. If this is not available, please summarize the presenter's qualifications and relevant background to the presentation. ____________ __________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Describe or attach a copy of the method of registration, documentation of attendance to verify the number of hours an individual attended, and the certificate of completion that will be awarded. Please submit $10.00 per credit hour with the above information to: NASW, Hawai'i Chapter 677 Ala Moana Blvd. Ste 702 Honolulu, HI 96813 INSTRUCTIONS FOR COMPLETING THE APPLICATION FOR SOCIAL WORK CONTINUING EDUCATION HOURS Please answer each item completely. Incomplete applications will be returned to the applicant. A separate application must be submitted for each event. The policies for approval of continuing education hours are as follows: Policies Continuing education hours will be approved in 1- hour increments only. Continuing Education hours will be approved for conferences, workshops, and trainings that are a minimum of 2 hours teaching time. Continuing Education hours will be approved for agency in-service trainings that are at a minimum of 1 hour teaching time. There will be an application fee of $10.00 per credit hour. If the same program or event will be offered at different times or at different locations, a $10.00 per credit hour fee must be submitted for each time the program will be offered. Approval of CEUs does not constitute NASW's endorsement of event nor does it necessarily represent positions of NASW. Criteria for Approving Social Work CE Hours The criteria to determine whether social work continuing education hours will be awarded will include but is not limited to: 1) relevance to social work practice; 2) a clearly articulated statement of the educational goals and objectives; 3) qualification of presenter (by educational degree and/or other experience in training); 4) evaluation instrument; 5) documented method for registration, verification for hours of attendance and certificate of completion of training A check or money order payable to NASW Hawai'i Chapter must accompany the application. Applications must be received by NASW Hawai'i Chapter at least two (2) weeks prior to the event. Verification will be mailed to the applicant stating the number of continuing education hours approved. Applicants may advertise that "NASW CEU credits are pending". If verification for approval is not received before the event, participants names and addresses requesting CEUs should be documented and certificates of approval may be sent after the event.
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