Thank you for your interest in developing a program for NYSPA.

Please submit this form at least 4 weeks (preferably 8 weeks) before your preferred program date. This allows staff sufficient time to obtain all necessary approvals and properly promote the session in advance.

NYSPA staff will review your submission and confirm date availability.

If you have any questions, please contact NYSPA's Education Coordinator at jamin@nyspamail.com.

PROGRAM INFORMATION

1.Program Format

In-Person

Hybrid

Virtual/Online

2.Requested Program Date

3.Alternative Program Date

4.Requested Program Start & End Times

5.Session Title

6.Session Description

7.Learning Objectives

8.Program Rationale

Presenters must demonstrate that the content to be presented is either (a) supported by empirical research and/or (b) related to legal and ethical issues that impact psychology.

Check one box below that is the primary focus of your program.

Program content relates to psychological assessment and/or intervention (e.g., therapy) methods that have peer-reviewed published support. Provide either (a) three relevant references (in APA citation format) that offer empirical support for the approach or (b) a published list (such as that put out by Division 12, Clinical Psychology, of APA) of endorsed, evidence-based treatment approaches that includes the approach to be presented.

Program content is focused on topics related to psychological practice, education and training, or research OTHER THAN assessment and intervention/therapy and is supported by empirical research. Provide three APA-formatted references offering evidence-based support for the program’s content.

Program content is related to legal and ethical issues that impact psychology. This relationship needs to be specified in detail, with supporting citations.

For the box checked above, please provide the requested specific supporting details and citations that demonstrate how the program meets the rationale checked.

Please ensure that references are peer-reviewed and published within the last 10 years, and that the learning objectives are stated in measurable, observable terms.

9.Citation 1

10.Citation 2

11.Citation 3