Program Proposal Application
The Michigan State University School of Social Work Continuing Education Program is interested in recruiting skilled
and experienced professionals who wish to share their expertise as trainers for the program. Course offerings are based on
previously identified training needs and topics requested by our customers. Applications will be reviewed during the
months of January, February, May, June, September, and October. They must be received by the 14th of any of these
months in order to be responded to by the 30 th of the same month, otherwise, you will hear on the next stated review
month. Please complete this application in full. Brochures, handouts, and other materials you may have used for this
presentation in the past can be attached as appendices but will not be considered independent of this application.
Applications must be typed.
Name:
Degree(s):
Current job title:
Email address:
Phone number:
Program title:
Program description (3-10 sentences):
Program objectives (minimum of 2):
As a result of this course participants will be able to:
Program length (1 - 24 hours):
Detailed program agenda (what topic will be covered for what time period):
Skill level (must be targeted to an audience with a minimum of an LMSW) i.e. beginning, intermediate, advanced – may
also be a blend of multiple skill levels. Please describe how you determine this:
Relevance to social work practice:
Presenter biography (3-5 sentences):
Please attach a resume/C.V.
Location(s) and audience(s) to whom you have previously presented this program:
(Organization/School, etc. and audience composition) Please attach a copy of evaluations or summary of evaluations
Reference of a person who coordinated or participated in this training:
Please attach copies of handouts if available
Bibliography:
Must include at least three references from professional books or journal articles, one of which must be within the last 5 years
Typical AV equipment needed for this presentation:
Instructor qualification:
The Michigan State University School of Social Work Continuing Education Program strives to provide quality
professional development programming for participants. In order for our program to award participants continuing
education contact hours, instructors must meet certain criteria identified by the Association of Social Work Boards
(ASWB). By completing and signing this form, you certify that you have read, understand, and meet the instructor
qualifications for the educational activity/activities for which you may be hired as an instructor.
Please check the applicable boxes( one of the first 4 must be true):
 I have extensive experience to include no less than five years of practical application or research involving the
subject taught in the course
 I am a faculty member of an undergraduate or graduate school of social work
 I have received specialized graduate or postgraduate level training in the subject taught in the program


I have professional qualifications in good standing with my professional regulatory board (if applicable)
I have the following licenses and credentials (please list):
Type
State
Expiration date
(continue on back if needed)
As a requirement of the body which approves Michigan State University School of Social Work to provide continuing
education for social workers (Association of Social Work Boards or ASWB), I understand I must adhere to the published
time schedule of continuing education hours. One continuing education hour equals 60 minutes of instruction time.
Instruction time includes time allotted for program attendees to complete evaluations. I understand instruction time
excludes welcomes, introductions, breaks, tours, and exhibits. ASWB ACE, MSU School of Social Work Continuing
Education program’s accrediting body, requires you agree to abide by the advertised program time–no exceptions.
Name:
Signature:
Questions? Please send an email to swkce@msu.edu or call the Continuing Education Program at (517) 353-3060. Fax
this and accompanying documents to (517) 353-3599 or mail to:
MSU- Social Work Continuing Education
Baker Hall 655 Auditorium Rd, Suite 212
East Lansing, MI 48824
Thank you for your submission