AFCC MN TRAINER APPLICATION
Are you applying as a primary/coordinator trainer or an assistant trainer? Note that all trainers must complete a curriculum/trainer program provided by AFCC MN Training Committee. Please provide the following information– for some questions your curriculum vitae or other summary of information such as professional credit reporting, which is attached to this form will be appropriate as an answer. (Attach at bottom of application.)
Street Address Line 2
District of Columbia
Please enter a valid phone number.
Name of employer or professional practice
What is your education background since high school?
What professional degrees, board or professional certifications do you hold?
Describe your professional employment history including approximate dates, employers and positions held.
Family Process Training
What training have you completed in ADR theory, methods and processes including the 40-hour family law mediation training?
Are you a Rule 114 Qualified Neutral?
What training do you have regarding custody evaluation training?
In the last five years what training have you had in family issues such as:
Resources for families
Effects of divorce on children
What ADR processes have you participated in as an attorney, mental health provider, coach or expert?
What specific ADR processes have you personally provided as a neutral? How many over what period of time?
Have you conducted custody evaluations? How many over what period of time?
For any trainings you have conducted:
Were you a primary, assistant, or subject matter trainer? Please describe each training below? ~ Please copy and paste info below for each training.
1. Were you a primary, assistant, or subject matter trainer? 2. The subject matter? 3. Length of the training? 4. When was the training provided? 5. For what organization or entity the training was provided? 6. Did you receive a Rule 114 certification or equivalent for a training? 7. What was the specific course taught and for how many credits?
What experience do you have training online?
What experience/training do you have with adult learning?
Have you created, assisted, or contributed to a curriculum for the training(s) you provided? Were the trainings approved by the governing entity if any?
What teaching or training experience do you have regarding domestic violence?
What geographic area do you typically work in?
What is the proportion of self-represented versus represented cases for which you have provided services?
What approximate proportion of your cases in which you are providing services include issues of cultural diversity?
What approximate proportion of your cases in any role have included issues of domestic violence?
Contributions to Professional Education
In the last ten years what articles/chapters or books have you published or updated?
What courses have you taught including higher education classes as an instructor or guest lecturer, conference presentations, lectures?
Have you ever been publicly disciplined by a licensing entity or professional board? If so, provide details.
Considering the attributes described on the AFCC Trainer Recruitment Fact Sheet, is there any other information you would want to provide?
For some questions your curriculum vitae or other summary of information such as professional credit reporting, which is attached to this form will be appropriate as an answer.
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