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

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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)

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