Clemson University



Olweus Bullying Prevention Program (OBPP)

Application for Participation in the Trainer Certification Course (TCC)

Each applicant interested in seeking certification in the Olweus Bullying Prevention Program is asked to:

(1) Complete and sign this application,

(2) Read the Trainer-Consultant Certification Requirements form (separate attachment),

(3) Submit a current resume, and

(4) Ensure that all documents are submitted prior to the deadline.

Tuition cost is $3,925.00. Upon approval into the selected OBPP TCC, an Acceptance Letter will be sent to each applicant. Participants must use the link provided in the letter to register for the TCC. Once registered, an Order Receipt that will serve as your invoice will be emailed to you at the address provided. Payment is due 30 days after receipt or 5 days prior to the start of the TCC if scheduled less than 30 days from receipt of Order Receipt.  

Indicate below the Part 1 that you would like to attend. Note that both Part 1 and Part 2 are required. More details about the certification process are on the document, OBPP Trainer-Consultant Certification Requirements.

      Greenville, SC; October 2-4, 2018 - In Person TCC

Application packets are currently being accepted through Friday, September 21, 2018.

      Chelsea (Boston), MA; November 28-30, 2018 - In Person TCC

Application packets are currently being accepted through Monday, November 12, 2018.

      Greenville, SC; March 5-7, 2019 - In Person TCC

Application packets are currently being accepted through Monday, February 18, 2019.

      Greenville, SC; October 1-3, 2019 - In Person TCC

Application packets are currently being accepted through Monday, September 16, 2018.

Your signed application and resume may be submitted by email, fax, or mail to:

Clemson University

Institute on Family & Neighborhood Life

ATTN: June Jenkins

2035 Barre Hall, Clemson, SC 29634

Email: june2@clemson.edu

Fax: 864-656-6281

If you have any questions about the application process, please either contact June by email at june2@clemson.edu or call the Olweus Office at (864) 656-6271.

Personal Information

Name:     

Work Affiliation (name of School District/Organization):      

Current Position with School/Organization:      

Name of School Building (if applicable)      

Work Address: Street:      

City:       State:       Zip Code:       Country:      

Work Phone:       Work Fax:      

Work Cell Phone, if applicable:       Work E-mail Address:      

Home Address (required):       City:       State: Zip Code:       Country:      

Home Phone:       Personal Cell Phone:      

Personal E-mail Address:      

Please list your educational degrees and areas of specialization.

     

Please provide a brief description of your current job responsibilities. How long have you held this position?

     

Please briefly describe any relevant experiences you have in working with schools and/or community youth organizations:

     

Have you previously trained adults? In what content areas or programs?

     

Please describe your involvement in any anti-bullying- or other violence-prevention programs.

     

How did you learn about the Olweus Bullying Prevention Program?

     

How familiar are you with the Olweus Bullying Prevention Program?

                       

very moderately not very not at all

familiar familiar familiar familiar

Have you received any previous training in the Olweus Bullying Prevention Program?

      Yes       No

If yes, please provide a description of the training:

     

How would becoming a certified OBPP Trainer-Consultant relate to your current job or consulting work?

     

Are you aware of other certified Olweus Trainer-Consultants in your area? If yes, who are they? How might you collaborate with them?

     

If you were certified in the Olweus Bullying Prevention Program, how many hours per week would you be able to commit to the program?

     

Information About Your Site(s)

Some potential Trainer-Consultants in the OBPP may be affiliated with one or more schools, school districts, or community youth-serving organizations that intend to implement the Olweus Bullying Prevention Program. For example, an applicant may be employed by a school district that has a grant to implement the program in 15 schools within the district. It would be helpful for us to have information about such relationships. If potential Trainer-Consultants are affiliated with community agencies or are independent consultants, describe plans to locate schools or organizations for which OBPP training-consultation will be provided.

To whom do you anticipate providing training and consultation in the Olweus Bullying Prevention Program? Please provide the number of schools (with grade levels) and/or community youth-serving organizations and the cities in which they are located.

     

How do you anticipate that the Olweus Bullying Prevention Program will be funded in the sites noted above (e.g., school district, organization, a grant, parent-teacher organization, etc.)?

     

For what period of time would the funds be available?      

In your opinion, what is the level of commitment from school administrators/program directors in the sites noted above? (Check one.)

                             

very high high moderate low very low

I understand that, in order to be fully certified in the Olweus Bullying Prevention Program, I must adhere to the requirements stated on the attached document, Trainer-Consultant Certification Requirements. My current intentions are to seek OBPP Certification in the following category:

      National OBPP Trainer-Consultant

Intend to provide OBPP training and consultation to more than one site

      Single Site OBPP Trainer-Consultant

Intend to provide OBPP training and consultation to one site only

      OBPP Consultant

Intend to provide regular, ongoing consultation with sites that have already been trained in the OBPP

By initialing (1-5) and signing below, I affirm that:

____ 1. I read the Trainer-Consultant Certification Requirements document.

____ 2. I understand that I may change course to pursue a different category of certification, if my circumstances change.

____ 3. I grant permission to Clemson University and its employees or representatives, to take and use: photographs, videotape, audiotape, and/or digital images of myself for use in promotional or educational materials pertinent to OBPP/IFNL programs as follows:

• In printed publications or materials

• In electronic publications or presentations

• On the Olweus website (clemson.edu/olweus)

(not required for acceptance)

____ 4. I agree that my identity (select one): ______ may be revealed ______ may not be revealed

in descriptive text or commentary in connection with the image(s). I authorize the use of these images indefinitely without compensation to me. All negatives, positives, prints, digital reproductions, audio and video shall be the property of Clemson University.

____ 5. I understand that if substantiated complaints are made about training and/or consultation that I have provided that violate these stated requirements, I may be removed from lists of Olweus Trainer-Consultants.

Printed Name of Potential OBPP Trainer-Consultant

Signature

Date

Thank you for your application to become a Certified Trainer-Consultant in the

Olweus Bullying Prevention Program!

Notice of cancellation or requests to reschedule attendance at Trainer Certification Course (TCC) Part 1 must be made in writing to the Administrative Coordinator, Jessi Wilson (jwinkle@clemson.edu). If a confirmed participant cancels or reschedules his/her attendance at the selected TCC and training materials have been shipped, a nonrefundable fee of $100 will be charged to the applicant or his/her organization to cover administrative and shipping costs.  If a participant cannot attend a TCC, a substitute participant may attend in his/her place if a completed application is submitted and is approved by the Olweus Bullying Prevention Program. Specific deadline dates are included in the Acceptance Letter.

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