SECOE Conference Registration
Event Date: September 23rd and 24th, 2021
Event Address: BX Brainerd Crossroads, 4011 Austin St. Chattanooga, TN 37412
Contact us at 423-648-4951 or tonya.daniel@secoe.us
Email *
Name (Please put name as you want it on your certificate) *
License/Degree *
Email *
Personal Number *
Fax Number *
Agency/Group Practice *
Agency Address (Full Address Please) *
Agency Phone *
Briefly describe the services provided by you and/or your agency: *
What population do you and/or does your agency serve? Check all that apply: *
Required
In what format are these services provided? Check all that apply: *
Required
Please choose the setting in which you offer services: *
Required
Counties Served *
I will be attending both days of the conference, and am aware that attendance both days is required for Type 1 credits and Continuing Education Units. (Please call 48 hours in advance for cancellation) *
If participant would like an APA (Psychologists) certificate there is a $30 fee, and the certificate will be sent via mail. Please check APA Type 1 CE credit option below. All others may select NASW CEUs. *
*The University of Tennessee Health Science Center is approved by the American Psychological Association to sponsor continuing education for psychologists. The University of Tennessee Health Science Center maintains responsibility for this program and its content. 12 hours of Type 1 CE credits for psychologists is offered. Southeast Center of excellence agrees to adhere to the APA Ethical Principles of Psychologists.* **This program was approved by the National Association of Social Workers-Tennessee Chapter (Provider NASWTN 2021-0071) for 12 continuing education units.** *
If you have needs that require accommodations or other special considerations, or if you need to discuss our grievance policy, please do not hesitate to contact the SECOE conference coordinator at 423-648-4951 or tonya.daniel@secoe.us. *
At this time we are unable to accomodate all dietary restrictions, however we do try to have a vegetarian and vegan option at our event. If you are in need of this option please indicate below so that we can try to have enough of these meals available. *
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