2026-27 Advanced MSW Practicum Educator Training Registration Form

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Other

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Training Information

Wednesday, September 16, 1:00-5:00pm, In Person
This training is optional, and intended for experienced practicum educators.
The training session meets the qualifications for 4 hours of continuing education credit as required by the Board of Behavioral Sciences for MFTs and LCSWs (Provider Number PCE784).

Registrant Information

First and Last Name *

Email address (confirmation information will be sent to this email address) *

Phone # *

Phone #, part 1

Phone #, part 2

Phone #, part 3

ext.

Phone #, part 4

Agency/Organization Name *

Please select your role: *

Practicum Educator (formerly "Field Instructor")

Task Supervisor

Other

Please specify "other" *

A total of 4 free CEU's are available for successfully completing the training. Are you interested in collecting CEU's? *

Yes

License Number *

Please provide your license number (LMFT or LCSW). Note: We cannot provide CEU certificates to those who do not provide their license number or for those with an ASW.

Comments/Questions

2026-27 Advanced MSW Practicum Educator Training Registration Form

Training Information

Wednesday, September 16, 1:00-5:00pm, In Person

This training is optional, and intended for experienced practicum educators.

The training session meets the qualifications for 4 hours of continuing education credit as required by the Board of Behavioral Sciences for MFTs and LCSWs (Provider Number PCE784).

Registrant Information