BABIES CAN’T WAIT CONTINUING EDUCATION

WORKSHOP SPONSOR PRE-APPROVAL FORM

This form is to be used for pre-approval of conferences/trainings/or workshops for Continuing Education credit through Babies Can’t Wait.  This form must be postmarked/ fax dated  to Project SCEIs at least FOUR WEEKS PRIOR to the date of the conference/training/or workshop.  Upon approval of your workshop, you may advertise pre-approval by Babies Can’t Wait/Project SCEIs  for Continuing Education credit on your program brochure.

SECTION I.               DEMOGRAPHIC DATA OF THE CONTACT PERSON:

Name: __________________________________________________________________

Agency/Position: _________________________________________________________

Address: ________________________________________________________________

Telephone: (_____)______________________

SECTION II.             DEMOGRAPHIC DATA OF THE TRAINER:

Name:__________________________________________________________________

Agency/Position:__________________________________________________________

Address: ________________________________________________________________

Telephone: (______)_______________________

Please attach a resume or vita of the featured trainer.

SECTION III.            PROGRAM INFORMATION:

Conference/Training/Workshop Title:_________________________________________
_______________________________________________________________________

Topic(s):________________________________________________________________

Content  focused on children of what age group?_________________________________

Date(s)/Hours:____________________________________________________________

Location: ________________________________ City:  __________________________

Please attach the proposed agenda including schedule and/or the program brochure.
______________­­­­________________________________________
ALONG WITH REQUESTED DOCUMENTATION, MAIL TO:

Project SCEIs CE Committee; EPSE; Georgia State University;

P.O. Box 3979; Atlanta, GA 30302-3979

For office use only:

SECTION IV.         BCW COMMITTEE REVIEW:                                     Date  reviewed: ____________
ID Number:_______________________

Approved:                ________                Hours:_______  Children and families
                                                                                         _______  Children with disabilities and their families

Disapproved:       ________ Reason:___________________________________________
______________________________________________________
UpdatedSeptember 22, 2003

Directions and Information for Sponsor Pre-Approval Application

 Conference, training or workshop sponsors who wish to offer Project SCEIs/BCW Continuing Education Hours to attendees should use WORKSHOP SPONSOR PRE-APPROVAL FORM. The request MUST meet the following requirements in order to be considered:

¨       The request MUST be postmarked or fax-dated to Project SCEIs no less than four weeks in advance of the conference, training or workshop date. NO exceptions!!

¨       The information submitted must contain the following:

¨       Name of the featured speaker(s) with a resume or vita attached including educational background, highest degree earned, and training or experience in the topic area. If resume is not available please include relevant information on a separate sheet.

¨        Program description of the workshop (content and logistics)

¨       Agenda and/or information about hours, dates, and location.

¨       The focus of the conference, training or workshop addresses at least one of the following:
      A. Children, birth to age 8
      B. Families of young children (birth-8)
      C. A particular disability covered under Georgia’s BCW Program. 

¨       Continuing Education hours will be determined according to contact hours of the program.  For example, one contact hour = one hour of instructional time. Credit is not given for time at breaks, lunch or in the “housekeeping” elements of the event.