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Collaborative - Notice of Repeat Use

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

Notice of Repeat Use Form Instructions:

  • In order to repeat an approved STANDARD program on additional presentation dates, the repeated presentation(s) must meet the following requirements. If the repeated presentation does not meet the four qualifications listed below, you must submit a Standard Program Application for the modified presentation.
    1. Repeated program is being sponsored by original sponsor.
    2. Repeated program is being held within the approved licensing period.
    3. Repeated presentation has the exact same content, objectives, timeline, and instructional hours as the original program presentation.
    4. If the instructor is different, new instructor must have experience comparable to the original instructor. Provide that information in the space below.

  • If the repeated presentation does not meet the qualifications above, you must reapply for the modified presentation.

  • Use the same authorization number for the repeated dates.

  • You will receive a confirmation number after submitting this form. Keep this number for your records. You will receive no further contact from the Collaborative regarding your repeat submission unless there is a problem.

  • There is a $10.00 fee for submitting each Notice of Repeat Use form, however you may submit multiple repeat presentations for a single program on one form.

  • 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.


A. Submitter Information


B. Repeat Information

List the specific date(s) when the program will be repeated.
List any changes to the LOCATION or PRESENTER(S).

Please note that form(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:
Copyright 2001, NASWMA. All rights reserved.

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