Self Study Form
To receive credit for education which are not part of a formal workshop in which participants are supplied with a certificate to verify their attendance, you must complete the following questionnaire.  

Present this questionnaire to your licensor for approval towards the training credit. Which materials qualify for credit and the number of credits accepted will be determined by your licensor. If you have questions whether an activity, book, video or other material will be accepted, please contact your licensor to discuss it.
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Email *
Foster Parent Name: *
Who is your Foster Care Licensing Worker? *
Date of training: *
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Title of Material *
Format of Training *
Location of Training (If applicable) 
Length of Material (Book: pages, Video: time, Lecture: time)

Please note that for books/articles the provider will received 1 hour for anything 100 pages or less, 2 hours for 200 pages, etc. For therapy, foster parents must participate in the entire session. If foster parent is assigned homework (ex: specific reading, implementing specific plan) additional hours may be counted. For medical, training can be included for learning specific cares (ex: physical therapy, occupational therapy, etc.). 
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Please provide a brief summary of the content of this material: 
 *
How do you feel you will be apply to apply the information you learned to working with youth in your care?
 *
What did you find most interesting about the training and what insights were gained in completing said training?
 *
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