New York Mental Health Counselors Association
Continuing Education Presenter Application
Organization/University/Agency: (List all that apply)
Description of presentation: Presentation must include references to current research on your topic.
As required by the New York State Department of Education, please submit the
following by email with your completed form:
- A CV (resume) that documents your preparedness and experience in presenting on your topic.
Send your CV/resume in the following formats: PDF, DOC or DOCX. Do not send a JPEG.
Additional Presenter Name:
2nd Presenter - Organization/University/Agency: (List all that apply)
2nd Presenter Mailing Address:
* Your application will be forwarded to our continuing education committee for their review and
approval. They will contact you if they have questions and in regard to the status of your application.
Do you have a location, date and time scheduled for your proposed workshop? If so...........
Location: (If NYMHCA Regional Chapter, state which one)
Will this workshop be: (Choose all that apply)
~ a single workshop or event?
~ the first in a series of workshops with a unified theme?
~ a NYMHCA Convention workshop?
~ a live in-person webinar?
Please provide us with at least 3 learning objectives for your presentation. Each objective should begin
with "After this workshop, participants will....."
Here is the list of acceptable content for continuing education presentations for LMHC's as defined by the
NYS Education Department: (Choose as many as applies)
I hour of presentation = 1 contact hour (CEU)
Please describe the teaching methods you will use. For example: Powerpoint, overhead projector, printed materials, group interaction, lecture, practice demonstrations, etc. And tell us of AV needs for your presentation.
~ same workshop/same content given multiple times?
ie., DBT, Play Therapy, etc.
ie., CBT for Trauma Therapy, etc.
from medicine, law, administration and education
related to mental health counseling practice
which contribute to professional practice in mental health counseling and the health, safety and/or welfare of the public
~ a presentation given by an independent presenter or organization?
~ a presentation given for a NYMHCA regional chapter?
Please provide a 2 sentence description of your workshop to be used for advertising purposes: