Training proposal form

Please complete the following information if you are interested in proposing a play therapy training to be sponsored by the Arkansas Association for Play Therapy. If you have any questions, please email us at ar4apt@gmail.com

Presenter Name *

Presenter Name

First Name

Last Name

Email Address *

Phone Number *

Phone Number

(###)

###

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Degree and Credentials *

(e.g., M.S., Ph.D., LCSW, LPC, LMFT)

Are you a Registered Play Therapist, School-Based Registered Play Therapist, or a Registered Play Therapist-Supervisor *

Presentation Title *

Title must be 15 words or less and contain the phrase "play therapy" or "play therapists"

Presentation Description *

Please provide an overview of your presentation in 250 words or less; "play therapy" should be throughout the program description

Presentation Length *

Please select how many hours you are proposing for this training (not including breaks)

Learning Objectives *

Presentations 3 hours or less must have at least 3 learning objectives. For every additional hour of training, another learning objective must be created. "Play therapy" therapy must be in a majority of the learning objectives. For guidance on how to write learning objectives, please visit: https://www.apa.org/ed/sponsor/resources/objectives.pdf

Location for Training

If you have an address where you plan to conduct the training, please include it below.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Proposed Date for Training

What day are you proposing to have this training?

YYYY

Presenter(s) Biography *

Please include a brief biography for each presenter (45 words or less for each presenter)