audit report GSW-PGSW-RSW

Carmen

Description

LOUISIANA STATE BOARD OF SOCIAL WORK EXAMINERS GSW/PROV-GSW and RSW CONTINUING EDUCATION AUDIT REPORT July 1, 2009 - June 30, 2010 Name:____________________________________________________________________________________ Address:__________________________________________________________________________________ __________________________________________________________________________________ Credential No.:__________ Telephone: (_______)_____________________ Fax:_______________________ You must list 20 clock hours of continuing education including 3 hours in social work ethics. Ethics were to be completed between July 1, 2008 through June 30, 2010. Attach documentation verifying your attendance at the events. Please do not use initials when writing the names of the events or sponsoring organizations. Auditor Use Only Hours Month/Day/Year Hours Approved Not Approved Event: __________________________________________________ _______________ ________ _________ _________ __________________________________________________ Presenter: ________________________________________________________________________ Sponsoring Organization: ____________________________________________________________ ...

Informations

• Publié par: Mocher
• Nombre de lectures: 84
• Langue: Breton

Extrait

L OUISIANA S TATE B OARDOF S OCIAL W ORK E XAMINERS GSW/PROV-GSW and RSW CONTINUING EDUCATION AUDIT REPORT July 1, 2009 - June 30, 2010 Name:____________________________________________________________________________________ Address:__________________________________________________________________________________  __________________________________________________________________________________ Credential No.:__________ Telephone: (_______)_____________________ Fax:_______________________ You must list 20 clock hours of continuing education including 3 hours in social work ethics.Ethics were to be completed between July 1, 2008 through June 30, 2010. Attach documentation verifying your attendance at the events. Please do not use initials when writing the names of the events or sponsoring organizations.

 Auditor Use Only Hours  Month/Day/YearHours Not Approved Approved Event:__________________________________________________________ _______________ _________ _________  __________________________________________________ Presenter:________________________________________________________________________  SponsoringOrganization: ____________________________________________________________  Ethics 9 Event:_________________________________________________________ _______________ _________ _________  __________________________________________________ Presenter:________________________________________________________________________  SponsoringOrganization: ___________________________________________________________  Ethics 9 Event: _________ ________ __________________________________________________________ ________________  _________________________________________________ Presenter:________________________________________________________________________  SponsoringOrganization: ____________________ _______________________________________  Ethics 9 →

Month/Day/Year Hours  Auditor Use Only Hours Approved NotApproved Event:___________________________________________________ _________________ _________ _________  ____________________________________________ Presenter: ______________________________________________________________________ Sponsoring Organization: ___________________________________________________________  Ethics 9 Event:______________________________________________ _________________ _______ _________ _________  ______________________________________________ Presenter: _______________________________________________________________________ Sponsoring Organization: __________________________________________________________  Ethics 9 Event:______________________________________________ _________________ _______ _________ _________  ______________________________________________ Presenter: _______________________________________________________________________ Sponsoring Organization: ____________________ ______________________________________  Ethics 9 Event:_______________________________________________ _________________ ______ _________ _________  _______________________________________________ Presenter: _______________________________________________________________________ Sponsoring Organization: ___________________________________________________________  Ethics 9 Event:_______________________________________________ ______________________ _________ _________  _______________________________________________ Presenter: _______________________________________________________________________ Sponsoring Organization: ______________________ ____________________________________  Ethics 9 Event:______________________________________________________ _______________ _________ __________  _______________________________________________ Presenter: _____________________________________________________________________ Sponsoring Organization: __________________________________________________________  Ethics9

LICENSEE NAME_____________________________________ ADDRESS _____________________________________  _____________________________________  _____________________________________

*************************************************************************** AUDITOR USE ONLY: _____An Audit of this licensee’s continuing education report has been completed and the documentation has been found to be in compliance with all sections of Rule No. 317.  _____An audit of this licensee’s continuing education report has been completed and has revealed that the documentation is not in compliance with Rule No. 317 for the following reason(s): _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ Recommendation: _________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ Reviewed by:_____________________________________________Date:_____________________________ ****************************************************************************************************** Questions concerning your AUDIT should be directed to:  ASWB  LOUISIANA-CEAUDIT Box 1508 PO  Culpepper,VA 22701  Phone:[phone]  Fax:[phone]  ContinuingEducation Requirements can be viewed on our websitewww.labswe.org.  SeeRule No. 317 of theRules, Standards and Procedures.