Attendance Verification Form - National Association of Social Workers Texas

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Workshop Attendance Verification Form CE Request

Attendance Verification Form CE Request

NASW/Texas offers continuing education credit for workshops and maintains records for participants for three years. The following information is necessary to maintain our files and award your credit. If certificates are lost, copies will be provided to members at no cost. Non-members will be charged $10 for a certificate replacement.

Upon submission of your form, please allow up to 6 weeks, at the latest, to receive your emailed CE certificate.

If you have any questions regarding your certificate, email Taylor Sambrano, Membership Engagement and Communications Specialist, at tsambrano.naswtx@socialworkers.org.

Attendance Verification Form
First Name		Last Name
Name to be listed on CE Certificate
Credentials
Email Address *
Full Address (Include City, State & Zip) *
Phone Number *
Are you an NASW Member? *	Yes No
Is this a branch-related workshop?	Yes No	If so, which branch?
Title of Workshop Attended *
Date of Workshop *
Workshop Location *
Presented by *
Number of Total Approved CE Hours *
Number of Ethics Hours *Enter 0 if no ethics hours.		Number of Supervision Hours *Enter 0 if no Supervision hours.
Number of Cultural Competency Hours. *Enter 0 if no cultural competency hours.

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Attendance Verification Form CE Request