National Association of Social Workers - Pennsylvania Chapter



Pennsylvania Certification Board Annual Conference 2019Lancaster, PA on April 15 - 16, 2019 These credits are for licensed social workers, licensed clinical social workers, licensed marriage & family therapists, and licensed professional counselors, as approved by NASW-PA. To obtain your CE Certificate complete all of the information on this page, read the disclaimer, and sign the bottom of this page. Evaluations for each workshop must be complete to receive credit for attending the workshop. You may fax; email or mail your packet to Alicia Newkam at anewkam.naswpa@ or mail NASW-PA 1000 Bent Creek Blvd, Ste 40; Mechanicsburg, Pa 17050 along with a certificate fee of $20 for Members of NASW or $35 for non-members made payable to NASW-PA..PLEASE PRINT CLEARLY, as this name will be printed on your CE certificate which will be EMAILED:Name: ________________________________________________ Credentials _________________NASW Member: NOYES, Membership # (not necessary) ___________________________ Address: _______________________________________________________________City, State, Zip: _________________________________________________________Phone _____________________________________E-mail ____________________________________@ __________________________Total of ALL Workshop CE’s ________(max 13.75 CEs)By signing this statement, I attest to the fact I have attended all workshops evaluated within this continuing education packet in their entirety and that all of the information in this packet is accurate and correct. I take full responsibility for attending each session, completing these workshop evaluations, and submitting this packet, as outlined above. NASW-PA is neither legally liable nor responsible for the accuracy or completeness of this packet. NASW has been designated as a pre-approved provider of professional continuing education for social workers (Section 47.36), marriage & family therapists (48.36), and professional counselors (49.36) by the PA State Board of Social Workers, Marriage & Family Therapists, and Professional Counselors.Signature: _____________________________________________ Date: ____________________************************************************************************************If you would like to pay by VISA or MasterCard fill the following information, if not please include check or money orderName on Card: _____________________________________________________________CC #__________-___________-_________-_________ Exp:___________ CCV (3 digit):_________Signature of authorization:___________________________________________________________Monday, April 15, 2019. Credits will be earned when the session is evaluated.0.75 CE8:00 am The Evolving Addiction Workforce By Mary Jo Mather EXCELLENTABOVE AVERAGEAVERAGEBELOW AVERAGEPOORCourse met my expectations:54321Instructor’s presentation style:54321Comprehensiveness of presentation:54321Thoughts on session:___________________________________________________________________________1.5 CE9:00 am The Peer Workforce: The Power of the Peer By: Ramon Cruz; Joan Erney; Stephanie Hastings; Brandee IzquierdoEXCELLENTABOVE AVERAGEAVERAGEBELOW AVERAGEPOORCourse met my expectations:54321Instructor’s presentation style:54321Comprehensiveness of presentation:54321Thoughts on Session: __________________________________________________________________________2.5 CE11:00 am Breakout: ___________________________________________________________EXCELLENTABOVE AVERAGEAVERAGEBELOW AVERAGEPOORCourse met my expectations:54321Instructor’s presentation style:54321Comprehensiveness of presentation:54321Thoughts on session: __________________________________________________________________________2.5 CE3:00 pm Breakout: ___________________________________________________________EXCELLENTABOVE AVERAGEAVERAGEBELOW AVERAGEPOORCourse met my expectations:54321Instructor’s presentation style:54321Comprehensiveness of presentation:54321Thoughts on session: __________________________________________________________________________Tuesday, April 16th, 20191.5 CE8:00 am Notes from the Field By: Thomas Deitzler; Beverly J. Haberle; William MilchakEXCELLENTABOVE AVERAGEAVERAGEBELOW AVERAGEPOORCourse met my expectations:54321Instructor’s presentation style:54321Comprehensiveness of presentation:54321Thoughts on session: ___________________________________________________________________________2.5 CE10:00 am Breakout: ___________________________________________________________EXCELLENTABOVE AVERAGEAVERAGEBELOW AVERAGEPOORCourse met my expectations:54321Instructor’s presentation style:54321Comprehensiveness of presentation:54321Thoughts on session: __________________________________________________________________________2.5 CE1:30 pm Breakout: ___________________________________________________________EXCELLENTABOVE AVERAGEAVERAGEBELOW AVERAGEPOORCourse met my expectations:54321Instructor’s presentation style:54321Comprehensiveness of presentation:54321Thoughts on session: __________________________________________________________________________Thank you! ................
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