Bapp Portfolio Review - Course Evaluation Form - Certified Addiction Counselor (Cac) - South Dakota Department Of Social Services

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BAPP PORTFOLIO REVIEW – COURSE EVALUATION FORM
CERTIFIED ADDICTION COUNSELOR (CAC)
___________________________________________________
NAME:
PHONE: ________________________________________
ADDRESS: _______________________________________________________
CITY, STATE, ZIP: __________________________________
BAPP policy allows for up to three courses to be reviewed for a fee of $25. For more than three course reviews, please complete another form and
submit the additional fee. (Note: The Portfolio Review fee is $25 for every three course reviews.)
Prefix –
Course
Name of
Name of Course
Sem.
Grade
Term
Comments
Board
Requirements
College or
Course
Hrs.
Taken
Approval
University
Number
Yes / No
Intro to Alcohol
Use and Abuse
Intro to Drug Use
and Abuse
Alcohol and Drug
Group Counseling
Ethics for the
Alcohol & Drug
Professional
Foundations of
Individual
Counseling
Alcohol and Drug
Treatment
Continuum
Counseling
Families with
Alcohol or Other
Drug Issues
Diverse
Populations
Alcohol & Drug
Specific Elective
Please return this form(s); two copies of each syllabus; transcripts - unofficial are acceptable at this time; and, the appropriate fee. Send all information
st
to: BAPP, 3101 W. 41
Street, Suite 205, Sioux Falls, SD 57105.
BAPP Reviewer: ___________________________________________________________
Date: ______________________________
Revised 2/12/16

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