Training Accreditation Form

Please complete the following questions concerning the training you are seeking accredidation for. Trainers who wish to provide a training at the Association's Annual Conference held each year in September need to complete the form as well for training consideration.

Please be sure to print the completed application once done for your records. Thank you.

Please check which type of training you are requesting accreditation for. *

Competency Training
Proficiency Training
Annual Conference

Entity Organizing Training - County, Dept., Outside Agency, Etc. (please do not use acronyms so that we clearly know who the organizing entity/agency is)*

Contact Name (First/Last)*

Contact Phone Number*

Contact Email Address*

Re-enter to confirm

Date of Training:*

Title of Training:*

Length of training (in hours):*

Training Location Name: If for the Association's Annual Conference, please put "Conference"*

Location Address: *

Name of Trainer:*

Trainer Phone Number:*

Trainer Email Address:

Re-enter to confirm

Trainer's Bio:*

Please select the group of programs served by the proposed training.*

Description of Training including training objectives:

Please provide an overview of the training. Course overview must be able to answer the following questions:

What are the learning outcomes a member will walk away with after taking this course?
Is the curriculum focused, coherent, and appropriately challenging for the subject being covered?
Does the curriculum align with one or more of the Program area core competencies or proficiencies listed in the Standards & Certification Guide? (Please list all core competencies or proficiencies addressed by this training)

Please provide overview and core competencies/proficiencies met by course here. *

Please add any additional comments here for consideration by the Standards & Certification Committee.

Submit