NASW-DE CE Approval Application

Thank you for applying for approval for continuing education credits provided by the National Association of Social Workers - Delaware Chapter. The chapter offers individual course approvals to those who offer cutting-edge, beneficial courses to Delaware social work professionals. The chapter is committed to ensuring that members of our profession demand high quality education.
Application for Pre-Approval of a Presentation for Continuing Education Hours
CE - Course Approval Application Form

Course approval: Each approval is valid for the biennial licensing period in which it was submitted (Currently 2/1/2023-1/31-2025). During this time, the approved course can be offered an unlimited number of times as long as there are no content and/or presenter changes.
UPDATE: This form can no longer be saved as a draft and returned to. If you are not ready to complete this application and pay in full, save all of your course information in a Word Document until you are ready to submit.
Application Instructions:

Please complete the application thoroughly; complete all sections. Be sure to include all attachments.

Applications are processed on a first come, first served basis.

Submit application information at least thirty (30) days prior to each program.
Applications cannot be reviewed unless payment and all requested information are received.

Allow 2 weeks for processing and review (after a correctly completed application and payment have been submitted) to be notified of the program status.
Please provide the information requested in the required field. Attachments cannot be substituted for the requested information.

All fields must be completed. Indicate n/a if the question is not pertinent to your course offerings.

Documents placed in the appendix and/or uploaded as attachments must be clearly numbered and labeled according to the section(s) they support.
Please be sure to attach documents required for the specific type of course you are providing.

For more information contact Makyla at mburke.naswde@socialworkers.org.
Contact Information:
Applicant or Organization Name:*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number *

Area CodePhone Number
Website URL:
Contact Person: *
Contact Person's Email: *
Contact Person's Phone Number: *
Have you/your organization had individual course approval with OTHER approval entities for the course in which you are submitting this application? If so, please include entity name, whether course was approved or denied and, if applicable, date approved and approval number: *
If this does not apply to you, please indicate N/A.
Presenter(s)
Presenter's name(s): *
Presenter's address(s): *
Email(s): *
Presenter(s) Phone Number (s): *
Presenter(s) License Number: *
Presenter(s) NASW Member ID:
Describe relevant presenter qualifications as they pertain to course: *
Presenter Resume: *

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Course Overview
Course Title: *
Course Location: *
Course date(s):
Course Description: *
Course Outline: *
This outline should display a course breakdown with a timed schedule of the day's event(s). It must include breaks, individual course segments, guided discussion, and activities, where applicable. (Meals, registrations, breaks, business meetings, Q&A, facility tours, award presentations, and other similar events are not eligible for credit.)
Course Length: *
Number of Continuing Education credits requested: *
(One credit for each hour of course work.)
Indicate the type of credits you are requesting:*

GeneralEthicsMandatory Reporting
Please describe registration process for potential attendees: *
Course Delivery Method(s)
Indicate Workshop Type:*

Live In Person Workshop or SeminarLive Virtual Workshop or SeminarPrerecorded / asynchronous workshop (Must include a copy of your entire program for review)
Course Objectives
List specific, clear, and concise learning objectives and/or outcomes for the course that are both behavioral and measurable: *
Course Content
Describe how course content reflects current (within the last 5 years) literature, materials and references and how it relates to one or more of the social work educational areas as listed in the state regulations.*
Identify and explain the skill levels (beginning, intermediate or advanced) targeted by this program. Please be specific. *
Evaluation
Please include a copy of your evaluation: *

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Records & Attendance
Please include a copy of your sample certificate, in accordance with guideline specifications:

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Please include a copy of your sample sign-in sheet, if applicable

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If this is a virtual event, please explain how attendance will be verified.
Promotion & Advertising
Please include a copy of course promotional materials:

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If there are multiple files, additional uploads can be made in the Appendix section below. Cancelof
Complaints/Grievances
Describe your process for responding to complaints and/or grievances from participants regarding course content: *
Describe your process for responding to refund requests: *
Appendix

Provide any additional supporting material for your proposal here. Be sure to clearly number and label according to the section it supports. Please also ensure that all items are in order as they appear in the application.
Appendix Upload 1:

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Appendix Upload 2:

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Appendix Upload 3:

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Appendix Upload 4:

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CE Approval Agreement
Please indicate agreement with a check placed on line next to each item. *

I understand that the information in this document will remain confidential, subject to disclosure within NASW-DE, 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. Should this course be approved, approval is valid for the biennial licensing period in which it was submitted.I understand that should I wish to offer the course following the expiration of an initial approval, I must submit a renewal application indicating that there are no content changes and pay the current renewal fee. Renewal is only allowed once, after that an application must be submitted again in full.I have read and approved this application, and verify that the information provided herein is accurate, consistent with social work ethical conduct and core values as defined in the “Explanation of Terms.”
Name of Applicant: *
If approved, your program will be listed on our approved listing. Provide the website address or contact email you wish people to use to get in touch with you:

Application Fees. Please select the appropriate fees for your application to finish your application. *

Individual or Non-Profit Application$100.00

Quantity

For Profit Application$200.00

Quantity

Non-Profit Conference Rate$450.00

Includes up to 5 hours of CEU applications. For conferences offering 6 or more CEU credits, please contact staff for discounted pricing.

Quantity

For Profit Conference Rate$800.00

Includes up to 5 hours of CEU applications. For conferences offering 6 or more CEU credits, please contact staff for discounted pricing.

Quantity

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Total $0.00

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Reviewer Results

For staff use only. If you are finished with the application, please click Submit above.
Application Status

ApprovedApproved conditionallyDenied
Approval Date

MonthDayYear
Date
Approval #:
Credits Approved:
Should be Empty:

Application for Pre-Approval of a Presentation for Continuing Education Hours

CE - Course Approval Application Form

Presenter(s)

Course Overview

Course Delivery Method(s)

Course Objectives

Course Content

Evaluation

Records & Attendance

Promotion & Advertising

Complaints/Grievances

Appendix

CE Approval Agreement

Reviewer Results