IDAMFC Professional Development Application

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Hello and thank you for your interest in working with IDAMFC to provide professional development to counselors and therapists throughout Idaho. Please complete the questionnaire to the best of your ability. The IDAMFC board meets once/month and will review applications during that time. If the board determines they would like to follow up on the application, a member of the IDAMFC board will contact you within 7 business days of the last meeting. If you have any questions or concerns, please email us at idamfcdivision@gmail.com

Primary Presenter Name *

Primary Presenter Email *

Primary Presenter Credientials *

Primary Presenter Phone *

Primary Presenter Organization or Affiliation (if any)

Are there multiple presenters? *

Yes

Additional presenter name(s) and email(s)

Primary Presenter Brief Biography *

Title of Program *

Summary of Program *

Learning Objectives (3-4 Condensed Bulleted Items) *

Please choose the NBCC category that best fits your presentation. *

Counseling Theory/Practice and the Helping Relationship

Human Growth and Development

Social and Cultural Development

Group Dynamics, Processing, and Counseling

Assessment

Research and Program Evaluation

Counselor Professional Identity and Practice Issues

Method of Presentation *

Panel

Lecture

Debate

Demonstration

Q&A

Number of NBCC clock hours requested *

Will IDAMFC need to provide a location/space for you? *

Yes

Other:

Will this program be compatible with online platforms such as Zoom or Google Meets? *

Yes

Other:

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