Continuing Education CEU Application

This application is for any individual, educator, or organization interested in providing continuing education units (CEUs) for their session participants. The National Association of Social Workers, California and Hawaii Chapter is a recognized provider for continuing education credits for LCSWs, LMFTs, LPCCs, and LEPs, authorized by the California Board of Behavioral Sciences and the Department of Commerce and Consumer Affairs. Most other states across the nation also accept the CA BBS-approved credits. Check with your state's licensing board to confirm regulations with your state license.

Please submit this CEU application EIGHT (8) WEEKS prior to your program start date. NASW-CA/HI cannot guarantee the review will be completed before the program date if submitted with less than 8 weeks available to review. If you wish to request that an application be reviewed within less than 8 weeks, a $75 expedited fee will be charged.

This application MUST BE accompanied by appropriate fee or paid by credit card before it will be reviewed.

To see if your educational activity meets social work professional development criteria for CEUs, you may email your program agenda or learning objectives to naswca@socialworkers.org for review prior to completing this online form.

A NASW-CA CEU Application: One application is necessary per educational activity/session regardless of length of time, number of CEUs offered, or if part of a larger conference, symposium, etc.

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CE FEE SCALE

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* 1. Primary Contact for CE Application Documentation, Pre/Post Course Reports, CE Correspondence with NASW-CA/HI

Name

Company/Organization

For Profit or Non-Profit?

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Which of the following best describes the CE

Session

Workshop

Conference

Multiday event

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* 3. About the Presenter(s) and Planning Person(s) Involved: Did you have a social worker involved in planning and evaluation of CE?

Yes, the contact person listed above is a social worker.

Yes, the social worker involved contact information will be included in the application

If Yes, Name(s) and License Number(s):

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* 4. If No, how do you plan to ensure that content is relevant and meaningful to the social work community, reflecting principles and standards of diversity, equity, and inclusion?

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* 5. Presenter/Speaker Information. If there are multiple presenter(s)/speaker(s), please see Question 6.

Presenter Name: First, Last

Professional Licensee Type, Number, State

Employer

Email Address

Phone Number

History of presenting/speaking on this lecture topic? Yes (when/where?) / No.

Event Title/Topic

Event Date

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* 6. If you have multiple presenters/speakers as part of a multi-level training course, panel, symposium or conference, please upload a document that informs us of each and all presenters/speakers name, professional licensee type, licensee number, state of licensure, employer, email address, phone number, and biography, as well as, presenting lecture topic which seeks CEUs, and any relevant history of lecturing on the subject here.

Please Note: any information not included will delay your CE application's review and approval.

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* 7. If you have presenters that are not licensed, please describe their relevant work experience that qualifies them to present on the topic for continuing education:

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* 8. Describe Presenter(s) relevant experience to the coursework provided:

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* 9. Are your presenter(s)/speaker(s) members of NASW? If so, provide all member names below.

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* 10. Please upload a copy of each/all Presenter(s) license(s) and/or resume/bio here. You will need to compile the documents to a single file for upload.

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* 11. Please upload a document that includes the following information for each session that you are seeking CEU approval. The document must include:

Course Title

Course Location (in Person, Virtual, Hybrid) If virtual, what platform will you be using?

Date & Time

Total number of CEUs seeking approval

Course Description: This may be provided in a paragraph form of 3-4 sentences. If your program has multiple course descriptions, there will be an opportunity to upload all course descriptions below.

Land Acknowledgement

A statement that describes how the workshop/training will include themes and topics relevant to Diversity, Equity, Inclusion, Intersectionality, Power Analysis, Accessibility, and Anti-Racism

Course Learning Objectives- Learning objectives provide direction in the planning of a training CE. They help to (1) focus on the learner’s behavior that is to be adjusted; (2) serve as guidelines for content, instruction, and evaluation; (3) identify specifically what should be learned; and (4) convey to learners exactly what is to be accomplished. In reviewing your application, we will be looking for learning objectives which include: identification of a specified action by the CE attendee that is: observable; measurable; and demonstrated by the CE attendee. Each learning objectives must be measurable.

Course Outline

sample provided here.

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* 12. CEU Certificate: Please upload a draft of your issuing CEU certificate (sample provided here). CE certificate must include:

For CA Applications:

First name, last name, and credentials of person receiving CEUs

Education title

Company/agency logo

Date

Location

The number of CE earned by the participant

This course meets the qualifications for Continuing Education for LCSWs, LMFTs, LPCCs, and LEPs as required by the California State Board of Behavioral Sciences, provided by NASW-CA

For HI Applications, please include the following:

First name, last name, credentials of person receiving CEUs

Education title

Name and titles of trainers

CE activity session start and end date

The number of CE earned by the participant

Signature of the activity sponsor

NASW Hawai’i Chapter CE authorization number and paragraph

This program is approved by the National Association of Social Workers-Hawaii Chapter (Approval #xxxxxxxxx-xxxx) for (xx) continuing education contact hours.

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* 13. Promotional Material: Please upload marketing content/promotional material related to this educational activity. Promotional material must include:

Provider's policy on refunds,

if session is part of a larger education activity (ie symposium, multi-day conference), please provide a program agenda,

clear, concise course description of the course content. (This may be provided in paragraph form of at least 3-4 sentences), and

learning objectives that applies to social work.

(sample provided here)

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* 14. Course Evaluation: Please upload course evaluation (sample provided here)

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* 15. Sign-In Sheet: CE approved educational activities are required to submit sign-in sheets for all CE credit recipients (sample provided here). Sign-In Sheets are required to have:

Participant name,

License type,

License number,

License state, and

Email address

Please upload your sign-in sheet template/document you will use to track attendance.

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* 16. DEI Statement/Policy: Please upload your organization/agency/company Diversity, Equity, Inclusion, Intersectionality, Power Analysis, Accessibility, and Anti-Racism statement.

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* 17. Learner Material: Please upload relevant presentation materials here or submit via email to naswca@socialworkers.org.

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* 18. Complaints and Grievances: Please tell us about your process for responding to complaints and/or grievances from participants regarding course content:

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* 19. Please tell us about your process for responding to refund requests:

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* 20. NASW-CA/HI CE APPROVAL AGREEMENT

I understand that the information submitted in this application will remain confidential, subject to disclosure within the NASW-CA CE Approval Program, upon request, necessary to comply with assessment criteria.

I certify that the information provided herein is accurate and, if approved, I agree to abide by all the criteria outlined in this application.

I understand that the payment is non-refundable, regardless of approval status.

I understand that NASW-CA staff may request adjustments to course content or other relevant components so as to secure CE approval, and I may be required to make those changes

I understand that all materials as indicated as necessary in the CE packet will need to be submitted to naswca@socialworkers.org two weeks post event (e.g., sign in sheets). In the event that any component is missing, all grievances about CE credits or lack thereof will be routed to me.

I understand that I will be responsible for distributing CE certificates to attendees as they comply with guidelines outlined in the NASW-CA CE packet.

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* 21. I attest to the CE Approval Agreement above. Please enter your full name here:

Please remit payment at CE Application Fee (Professional Development) Registration: CE APPLICATION FEE

Any applications that are submitted without accompanying payment will not be reviewed.

Would you like NASW-CA/HI's support in getting the word out about your event? Our platforms reach over 50,000 providers and social work leaders. Visit NASW CALIFORNIA News for advertising options.

For any questions regarding the CE application process, you may reach out to naswca@socialworkers.org.

Thank you for your application. We will confirm receipt to the email address provided above.