Continuing Education CEU Application

IMPORTANT INFORMATION FOR NASW-NM CEU APPLICATIONS

Materials should be submitted eight (8) weeks prior to your event date. Review will typically take place by NASW-NM staff within two (2) weeks of submission. Submitting an application does not guarantee approval of the event and the Chapter reserves the right to request content edits to meet the standards laid out in this packet.

Please understand that non-compliance can impact the Chapter’s Approved CE Provider standing with the licensing board.

NMBSWE Regulations – Continuing Education:

Ensure that social workers in New Mexico are providing the highest quality professional services.
Enhance the skills relevant to the social worker's professional activity

Fee Structure For NASW-NM Members and Entities

Individual or non-profit:

$20 per CEU
$75 late fee

Fee Structure for Non-NASW-NM Members and Entities

Individual and For-Profit

$30 per CEU
$75 late fee

Fee Structure For Marketing

Individual and For-Profit:

$20 one time social media post
$50 one time social media post, website and newsletter post

Question Title

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

Applicant Name

Applicant Title

Name of Company/Organization

For Profit or Non-Profit?

Address

City/Town

State/Province

Zip/Postal Code

Email Address

Phone Number

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* 2. Applications must be submitted at minimum eight (8) weeks prior to the scheduled program date.

I understand and agree to these terms

I am applying less than 8 weeks prior to my educational activity session, and I understand that I will be incurring an additional $75 fee if my application is processed.

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* 3. Will you offer Cultural Diversity, Equity and Inclusion, or Ethics credits?

Yes

If Yes, how many:

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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?)

Zip/Postal Code

Email Address

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.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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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.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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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

Date & Time

If virtual or on-demand, please provide the link and the name of the platform being used

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.

Course Learning Objectives

Course Outline

If requesting CEUs for an opening or welcome, Please include an overview

For cultural CEUs, please include a description of the cultural relevance to NM populations

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 12. CEU Certificate: Please upload a draft of your issuing CEU certificate. CE certificate must include:

The licensee must maintain proof of continuing education courses taken for the past four (4) years. The New Mexico Regulations and Licensing Department, Boards and Commissions, Board Of Social Work Examiners reserves the right to audit a licensee’s continuing education records as it deems necessary. The New Mexico Regulations and Licensing Department, Boards and Commissions, Counseling and Therapy Practice Board, and the NM Board of Psychological Examiners accept approved Social Work CE Units for license requirements. Please always check with your professional licensing board for current rules and regulations.

Company/agency logo

Education activity / session title,

Date,

First, last, credentials of person receiving CEUs

Number of CEUs issued

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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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

Program agenda

Clear and concise course description of the course content (3-4 sentences minimum)

3-4 Measurable Learning objectives that applies to social work

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 14. Course Evaluation: Please upload course evaluation.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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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.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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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.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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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-NM CE APPROVAL AGREEMENT

I understand that the information submitted in this application will remain confidential, subject to disclosure within the NASW-NM 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-NM 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 info.naswnm@socialworkers.org 10 days following the event (e.g., course evaluations and 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-NM CE packet and I am not

I must retain the attendance list for 3 years and the NASW-NM is not responsible for advertisement or communication with attendees.

I have the authority to sign on behalf of my employer and will ensure that all requirements are met.

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

Please remit payment using the following link CE Application Fee (Professional Development).

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

Would you like NASW-NM's support in getting the word out about your event? Our platforms reach over 50,000 providers and social work leaders.

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

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