Affiliated Trainer Application Question Title * 1. Your Contact Information Name Company (if applicable) Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number Question Title * 2. Enter your company website, if applicable Question Title * 3. Enter or paste your resume or CV Question Title * 4. Enter a 1-2 paragraph summary of your training expertise. (See examples here). Question Title * 5. Check your areas of training expertise Trauma-Informed Care Foster Parenting Behavioral Health Therapy Strategic Planning Child Welfare Programming Social Work Ethics Administration Residential Treatment and Group Care Addiction and Substance Abuse Juvenile Sex Offender Treatment Adoption LGBTQ Youth Family Services Other (please specify) Question Title * 6. Are you currently a certified trainer of the Ohio Child Welfare Training Program (OCWTP)? Yes No Question Title * 7. What geographical areas would you consider conducting trainings? NE Ohio NW Ohio SW Ohio SE Ohio Central Ohio Question Title * 8. Do you agree to adhere to Ohio Children's Alliance Core Values? Yes No Question Title * 9. Have you been convicted of, pled guilty to, or has any pending criminal action in any form of child maltreatment, child exploitation, domestic violence, or any offense listed under Ohio Administrative Code (OAC) 5101:2-5-09? Yes No Question Title * 10. Do you agree to provide Full and Public Partner member organizations of Ohio Children's Alliance a 10% discount on all training conducted during your period of affiliation with Ohio Children's Alliance? Yes No Question Title * 11. Have you conducted five or more trainings to Ohio child welfare or behavioral health agencies within the last five years? Yes No Done
