NASW-Michigan Aging/Gerontology Workgroup

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Thank you for your interest in the NASW-Michigan Aging/Gerontology Workgroup. Please complete the short survey below to let us know a little more about you and a member of the workgroup leadership will be in touch soon. Meetings are currently held via Zoom the 1st Friday of the month from 1-2:30pm.

This workgroup is composed of gerontology social workers from many fields of practice including hospitals, nursing homes, mental health, care management, private practice, law offices and more. Members pool their knowledge to promote sound social policies, share the latest trends in the field and provide valuable connections across agencies and regions.

The information gathered from this form will be accessible to Chapter leadership and workgroup members by request.

Email *

First Name *

Last Name *

Pronouns *

she/her/hers

he/him/his

they/them/theirs

ze/hir/hirs

Prefer not to include

Other:

Provide any social media handles of your choosing (optional):

Where are you located in the NASW-Michigan Regional map? *

Region 1 (Upper Peninsula)

Region 2 (Northwest - Emmet, Charlevoix, Antrim, Kalkaska, Missaukee, Osceola, Lake, Mason, Manistee, Wexford, Grand Traverse, Benzie, Leelanau)

Region 3 (Northeast - Cheboygan, Presque Isle, Otsego, Montmorency, Alpena, Crawford, Oscoda, Alcona, Roscommon, Ogemaw, and Iosco)

Region 4 (West - Oceana, Newaygo, Mecosta, Muskegon, Montcalm, Ottawa, Kent, Ionia)

Region 5 (Clare, Gladwin, Arenac, Isabella, Midland, Bay, Gratiot, Saginaw)

Region 6 (Capitol Region - Clinton, Ingham, Eaton, Shiawassee, Livingston)

Region 7 (Genesee, Tuscola, Huron, Sanilac, Lapeer, Saint Claire)

Region 8 (Oakland/Macomb)

Region 9 (Southwest - Allegan, Barry, Van Buren, Kalamazoo, Calhoun, Berrien, Cass, St. Joseph, Branch)

Region 10 (Southeast - Jackson, Washtenaw, Hillsdale, Lenawee, Monroe)

Region 11 (Wayne County)

Are you an NASW member? *

Yes

Please choose the most accurate option for you *

BSW or MSW student

BSW or MSW graduate with degree (unlicensed)

LLBSW or LBSW

LLMSW or LMSW

DSW or PhD

Other:

What is your area of social work practice? (ex: mental health, policy development, grantwriting, child welfare) *

How would you best describe your current social work role? *

What is your current capacity as it relates to joining the workgroup? *

Name added to group listserv, but I do not have the capacity to participate at this time

Attending regular meetings (Meetings are currently held via Zoom the 1st Friday of the month from 1-2:30pm)

Interested in a leadership position (ex: co-chair or sub-committee chair)

Other:

Required

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