Registration for Professional Advancement Offerings

Please complete the fields below to register for training workshops or EMAIL Jessica Smith at jsmith@crittentonwv.org

*Payment needs to be made with registration to confirm and hold spot. Free for DHHR and Crittenton Staff.

*Please note: Due to limited seating, if your cancellation is at least 48 hours in advance of the training, you will receive a full refund. If your cancellation is less than 48 hours in advance, you will receive a credit to attend a future training. If you have already paid and ‘no show’ to the training without prior arrangements made with the training coordinator, payment will not be credited.

Location: Crittenton Services, Inc. | 2606 National Rd., Wheeling, WV 26003

Name

First Name

Last Name

Email Address

Phone

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Agency

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Workshop

Training(s) you plan to attend:

CEUs/Hours

I am attending in order to receive:

WV Social Work Contact Hours/CEUs; WVBSW Provider # 490041

WV LPC Contact Hours/CEUs; WVBEC Provider # WVBEC-516

WV RN Contact Hours/CEUs; WVBRN Provider # WV1997-0186RN

***Participants should contact their individual state jurisdictions to review the current continuing education requirements for licensure renewal.***