Name: ECLS - 2021-2022.Core Competency Series
SKU: 66719
Price: 100.00 USD
Availability: InStock

Name*

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Email*

Agency/Organization*

Supervisor Name*

Supervisor Email*

Cell Phone (emergencies only)*

Do you need continuing education as a Licensed Social Worker or Professional Counselor?*

License Number (required for continuing education)*

What is your category of endorsement, if applicable?

Please indicate your discipline*

Please indicate your practice setting

Do you do home visiting? If so, which program?

How many years have you been doing IMH clinical work?

What are you hoping to gain from this training?

What questions do you have for the speaker(s)? These will be sent prior to the training day.

ECLS – 2021-2022.Core Competency Series

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