New Hampshire Psychological Association
72 North Main Street
Concord, NH 03301
Phone: (603) 415-0451 ~ E-Mail: office@nhpaonline.org ~ Web Site: nhpaonline.org
February 17, 2016
To Whom It May Concern:
Thank you for your interest in providing continuing education for mental health professionals in NH.
NHPA welcomes the opportunity to co-sponsor a program with your group.
The non-refundable fee for the NHPA Continuing Education Committee to consider co-sponsoring
workshops is $250.00, which should be sent with your proposal. If the workshop is approved, there is an
additional $20.00 cost per certificate issued which is paid after the workshop. Workshops that NHPA cosponsors provide credit for NH licensed psychologists. The Continuing Education credits are APA
approved so they are also applicable for all mental health professionals licensed under the NH Board of
Mental Health Practice and other mental health disciplines. Please have your registrants check with their
individual licensing agencies for rules pertaining to continuing education credits.
Other information we need 60-90 days prior to the program is as follows (see enclosed application):
* Title of workshop
* Program description
* Date
* Probable site - site needs to be accessible for physically disabled
individuals.
* Number of CE hours
* Presenters' vitae
Teaching ability is a primary pre-requisite for selection as a CE
instructor. Potential presenters should submit references regarding
teaching experience.
* Who will be invited to attend, in addition to psychologists.
NHPA will market your workshop as a co-sponsor on our website and in email to all mental health
professionals licensed in NH, with a link back to your registration page.
We will need to work with your organization from the planning stage until the completion of the
workshop. Please contact us about any meetings that will take place in order to help plan the event.
Enclosed is a letter of agreement and an Outline of Obligations for NHPA Co-Sponsorship that we will
work on together.
Sincerely,
Robert P. Blaisdell
NHPA Executive Director
LETTER OF AGREEMENT TO CO-SPONSOR
CONTINUING EDUCATION ACTIVITY WITH NH PSYCHOLOGICAL
ASSOCIATION
This agreement is between NH Psychological Association and
We do hereby agree to co-sponsor the CE activity with NH Psychological Association as
described below:
Co-Sponsor Name and Address:
Co-Sponsor CONTACT PERSON & PHONE NUMBER:
Date and times of Workshop:
Title of Workshop:
Name & Credentials of Presenter:
Brief program description:
Please enumerate 3-5 learning objectives for a 3 hr program and 5-7 learning objectives for a 5+
hr program:
Probable site:
Note: Site needs to be accessible for physically challenged individuals.
Number of CE hours:
Note: One CE = One Hour. One-half hours permitted.
Who will be invited to attend in addition to psychologists:
Please attach presenter's vitae:
Note: Teaching ability is a primary prerequisite for selection as a CE instructor.
Potential presenters should submit references regarding teaching experience.
We further agree to the conditions listed in the attached guideline for APA Approved CE
sponsorship as well as:
1. NH Psychological Association will be named as co-sponsor on all promotional material;
2. NH Psychological Association will maintain records and be responsible for ensuring quality
control. This may include being involved in all aspects of planning the events such as: attending
planning sessions and keeping in close contact with co-sponsor.
3. Co-Sponsor will consider the input of the NH Psychological Association in planning the
workshop content, specifically by reviewing a needs assessment.
4. There will be adherence to the Ethical Principles of Psychologists (available upon request);
5. Specific guidelines for promotional material will be met (see enclosed checklist);
6. Refund and cancellation policies will be stated on material.
Signed:
Co-Sponsor Representative
___________
Please print name:
_____
Name of Co-Sponsoring Organization:
Signed:
NH Psychological Association
Date:
_____________
_______________
Date: ___
_
Guidelines for Promoting Co-Sponsored Programs
with NH Psychological Association
The promotional brochure should contain the following information. Not every marketing tool
will need to have all the details of the program, but it must be noted that details are available
elsewhere.
These guidelines have been arranged as a check-off list for your convenience.
Clearly state on front of brochure both organizations as co-sponsors along with contact
information.
A full statement about Co-sponsorship and NHPA's approval status with APA needs to
appear once in the promotional material. This statement is as follows and must appear in
its entirety: “This program is co-sponsored by NHPA and (name of your organization). NHPA is
approved by the American Psychological Association to offer continuing education for psychologists.
NHPA maintains responsibility for the program."
Special Note: The phrase "CE Credits for Psychologists" may be used only when the
above statement is also used in the same promotional material.
Additional recommended statement: "This program offers continuing education
credits which are accepted by the State Board of Mental Health Practice for all N.H.
licensees."
Indicate schedule and format.
Clearly stated learning objectives (behavioral).
Indicate prerequisites for participants for whom activity is designed and skill level for
which the activity is appropriate;
Indicate number of CE Credits offered; ex: “3 CE credits.” Half-hour credits are
acceptable. Please do not use the term CEU.
Faculty credentials
Indicate cost of activity.
Items covered by fee for each activity (i.e. breaks, lunches)
Refund/Cancellation policy
PLEASE SEND A COPY OF COMPLETED BROCHURE TO NHPA