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Collaborative - Grand Rounds CE Application

The Collaborative of NASW and the Boston College and Simmons College Schools of Social Work

Grand Rounds CE Application Instructions:

  • Payment is required to process this online form. After you have submitted all forms, immediately submit payment by credit card online or by mailing a check.
  • You must have information for at least one session within the Grand Rounds at the time of your initial application. Additional session information may be submitted through the Grand Rounds Short Form online.
  • Partially completed forms cannot be saved online. Application must be filled out in one sitting.
  • Allow four (4) weeks for processing and review to be notified of the program status via email.
  • * = Indicates a required field
  • The application web pages times out after 45 minutes. Have all your information ready for input before you begin.


 

A. Submitter Information

Official authorization notice will be emailed to the below email address. The submitter listed below will be contacted by the Collaborative if there are any questions about the application form.


 

B. Sponsor Information

List the name of the sponsoring organization below.

Briefly describe what kind of work the sponsor does.
Has your organization been approved as a continuing education provider or had program approval with other professional associations?


If yes, list the full titles of the organizations below.
Has your organization been denied approval as a continuing education provider or had a program denied approval?



 

C. Grand Rounds Information

List the date range during which this Grand Rounds is being held.
Provide a brief series description for the entire Grand Rounds below.
List three learning (not teaching) objectives for the overall Grand Rounds series.
Describe how the course content applies to clinical and/or macro social work practice.

Type a timeline detailing the dates and titles of each session currently known (at least one session MUST be listed in full).

Select the program's targeted social work practice levels.



Select the instructional methods utilized during program.





List three (3) books or articles of reference from the bibliography. It is required that a short reading list be distributed to every participant for each program within the Grand Rounds series.

The evaluation form MUST list the program’s learning objectives in order to ascertain that teaching goals have been reached. Evaluation must be specific, written and measurable, and reflect the following areas:

  • Course content
  • Learning objectives (individual objectives must be rated)
  • Course appropriateness to participant’s education, experience and licensure level
  • Relevance to professional practice and currency of information
  • Instructor’s knowledge of subject matter and responsiveness to participants (if applicable)
  • Was subject matter presented effectively and clearly?
  • Instructor’s ability to utilize course-appropriate technology to support participant learning (if applicable)
  • Suitability and/or usefulness of instructional materials
  • Location, facilities, and technology
  • Administration of the program
  • Timeline of course adhered to the advertised


As the approved sponsor, you are responsible for the creation and distribution of the certificates of attendance to participants who complete the program. Certificates MUST have the participant’s name on it before it is stamped/authorized and given out.

Describe the process for awarding certificate of attendance.

 

D. Grand Rounds Sessions

Information for Session 1 is required. If you have information for more than five sessions, please use the Grand Rounds Short Form online to submit additional session information after you submit this online application.

SESSION 1

Select the exact number of instructional hours in Session 1.
List three (3) learning objectives specific to social work for Session 1.
List Session 1 instructor name with license and degrees, along with their current position.

SESSION 2

Select the exact number of instructional hours in Session 2.
List three (3) learning objectives specific to social work for Session 2.
List Session 2 instructor name with license and degrees, along with their current position.

SESSION 3

Select the exact number of instructional hours in Session 3.
List three (3) learning objectives specific to social work for Session 3.
List Session 3 instructor name with license and degrees, along with their current position.

SESSION 4

Select the exact number of instructional hours in Session 4.
List three (3) learning objectives specific to social work for Session 4.
List Session 4 instructor name with license and degrees, along with their current position.

SESSION 5

Select the exact number of instructional hours in Session 5.
List three (3) learning objectives specific to social work for Session 4.
List Session 5 instructor name with license and degrees, along with their current position.

Please note that application(s) will NOT be reviewed until payment has been received by the Collaborative.

How are you paying for this form?



National Association of Social Workers - Massachusetts Chapter
14 Beacon Street, Suite 409, Boston MA 02108
tel: (617)227-9635 fax: (617)227-9877 email: chapter@naswma.org
Copyright 2001, NASWMA. All rights reserved.

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