CE Collaboration Application (no app fee) - Clover Educational Consulting Group

Continuing Education Collaboration Application (no app fee)

Name of Person Submitting Application(Required)

First Last

Organization (if applicable)

Phone

Email(Required)

Website

Title of Proposed CE Program(Required)

Number of CE Credits to be Offered(Required)

Date of Proposed CE Program(Required)

If application is for a multi-day program, please list additional dates below.

Program Agenda

If application is for a multi-day program, please upload an agenda that clearly demonstrates the length of each session being considered for CE credit. Program agendas should include training days and times.

Max. file size: 128 MB.

Speaker/Presenter Name(Required)

First Last

2nd Speaker/Presenter Name (if applicable)

First Last

3rd Speaker/Presenter Name (if applicable)

First Last

If your proposed program has more than 3 speakers/presenters, please list additional names below and upload full CVs and Speaker/Presenter Bios in the corresponding uploads sections.

Speaker/Presenter Bio(Required)

Provide a brief speaker bio (150-word max).

2nd Speaker/Presenter Bio (if applicable)

Provide a brief speaker bio (150-word max).

3rd Speaker/Presenter Bio (if applicable)

Provide a brief speaker bio (150-word max).

Upload FULL CVs for all Speakers/Presenters(Required)

Max. file size: 128 MB.

Upload additional Speaker/Presenter Bios (if applicable)

Max. file size: 128 MB.

Description of the Training(Required)

Provide a thorough description of the training program. In doing so, please include all information about the training that will be made available to prospective attendees.

Learning Objectives for the Proposed CE Program(Required)

List the learning objectives for the proposed program. These should clearly describe a) what participants are expected to learn, and b) how participants can apply this knowledge in practice or other professional contexts. Use the following guideline regarding the number of learning objectives: 2 to 3 objectives for a 1- to 3-hour program; 3 to 4 objectives for a 4- to 6-hour program; or 5 to 6 objectives for a 7- to 8-hour program.

Need assistance creating learning objectives for your CE Program? Check out APA’s Guidance for Writing Behavioral Learning Objectives. Visit APA’s Website

Citations in APA Format(Required)

Provide at least 3 current (within the past 10 years) references. These references should be relevant to the proposed CE program, evidence-based, and from peer-reviewed sources.

Accuracy of References(Required)

I confirm that the author of this training has appropriately researched the proposed topic and that all references provided are accurate.

Artificial Intelligence (AI) Disclosure(Required)

APA Continuing Education Sponsor Approval requires disclosure of author use of generative artificial intelligence (AI) in the creation of continuing education materials. Was generative AI used in developing your CE program materials?

Yes, generative AI was used in developing program materials for this training. I understand that I must provide Clover with the full AI-generated output as a supplementary application upload.

No, generative AI was not used in developing program materials for this training.

Disclosure of Use of Generative AI

In the box below, provide a description of how generative AI was used in the creation of your CE program materials.

Documentation of Generative AI Output

Upload the full generative AI output associated with the use(s) described above. If you are not yet ready to submit this, you may opt to submit via email (continuing.education@clovered.org) one week before the training.

Max. file size: 128 MB.

Conflicts of Interest(Required)

APA Continuing Education Sponsor Approval requires disclosure of any relationships, commercial support, or commercial interests that could reasonably be construed as conflicts of interest. Please indicate whether you have potential conflicts of interest to report and be prepared to provide additional information as requested. If you are not sure, our team will be happy to discuss this with you.

I have no potential conflicts of interest to report.

I have conflicts of interest to report.

I’m not sure.

Conflicts of Interest Disclosure

Please use the space below to fully describe all known conflicts of interest associated with this training.

Not sure about conflicts of interest?

Please use the space below to provide any information you would like us to consider regarding potential conflicts of interest so we can determine whether any conflicts need to be addressed.