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Licensee Application For Approval Of Publications For Continuing Education Credit - South Dakota Board Of Examiners

South Dakota Board of Examiners for Counselor and MFTs

LICENSEE APPLICATION For APPROVAL of PUBLICATIONS For CONTINUING

EDUCATION CREDIT (ARSD 20:68:07:13)

A LICENSEE WHO DESIRES CONTINUING EDUCATION CREDIT FOR A PUBLICATION

SHALL APPLY TO THE BOARD FOR APPROVAL. THE BOARD SHALL NOTIFY THE

APPLICANT IN WRITING OF ITS DECISION WITHIN 20 DAYS AFTER THE REQUEST.

PLEASE INCLUDE A $25 REVIEW FEE.

PUBLICATION:

A Licensee who has written as first author a counseling article “accepted” for publication in a

recognized professional journal is allowed a maximum of ten contact hours each compliance

period for each original publication.

The letter of “acceptance to publish” must be submitted as verification along with this

completed form.

____________________________EMAIL _________________________

LICENSEE NAME:

__________________________________________________________________

ADDRESS

________________________

CITY/ST/ZIP_____________________________________PHONE

NAME OF PROFESSIONAL JOURNAL: ________________________________________________

DATE OF PUBLICATION:_________________________

HOURS REQUESTED:____________

[A maximum of 10 contact hours in each compliance period for

each original publication is allowed.]

DESCRIBE HOW THE PUBLICATION IS RELATED TO PROFESSIONAL COUNSELING AND/OR

MARRIAGE AND FAMILY THERAPY WITH AN EMPHASIS UPON SYSTEMIC APPROACHES OR

THE THEORY, RESEARCH, OR PRACTICE OF PSYCHOTHERAPEUTIC WORK WITH

INDIVIDUALS, COUPLES OR FAMILIES:

_________________________________________________________________________

PLEASE ATTACH ANY DOCUMENTS PERTAINING TO THIS REQUEST AND MAIL TO:

SD BOARD OF EXAMINERS for COUNSELOR and MFTs

PO BOX 340

PIERRE, SD 57501

(605/224-1721)

Licensee Application For Approval Of Publications For Continuing Education Credit - South Dakota Board Of Examiners