Trainer Certification - Customized Training Submission

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Trainer Certification - Customized Training Submission
CQL-Approved Customized Training is one that Certified Personal Outcome Measures^® (POM) Trainers develop. They utilize CQL POM training materials and concepts, designed to share the basic tenants of the Personal Outcome Measures^® in a format, timeframe, and for an audience meeting organizational needs. While you are not allowed to develop a different version of the POM Workshop, Customized Training is really open to the Certified Trainer’s creativity and need.

Some potential examples include:
- 1-day overview of the POM for DSPs and/or people supported
- 1-day training about one particular outcome or concept
- Curriculum that is utilized during new staff orientation
- Board member training
- “Refresher/Coaching” course for those doing POM interviews in an organization
The curriculum and materials must be submitted to CQL for approval via this application. Review the required elements below as you develop your training. Once you have created the training, complete each of the items below and attach the requested materials. Your POM Trainer Certification must be current to submit a curriculum for approval.

Please allow 20 business days for review. Approvals are for a 2-year period, starting from the date of your submission.
Today's date:

MonthDayYear
Date
2 years after today's date:

MonthDayYear
Date
Certified Trainer Information
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Organization*
Job Title*
Are you a current POM Certified Trainer?*

YesNo
In which measures are you currently certified?*

AdultsChildren & YouthBoth
Certification Expiration Date*

MonthDayYear
Are you willing to share this training with other CQL POM Certified Trainers?*

YesNo
Training Content
Please enter the title of your training:*
Is this training adapted from an approved Customized Training you accessed and downloaded via Box?*

YesNo
Please upload the training PowerPoint presentation file.*

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Please upload the training agenda.

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Please upload any trainer notes.

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Length of training:*

1-2 hours1 day2 dayOther
Target Audience:*

People receiving servicesDirect Support ProfessionalsSupervisors/ManagersExecutive LeadershipFamily MembersBoard Member / StakeholdersOther
Submission Checklist
Have you made sure to ...*

Add trademark "®" to Personal Outcome Measures®. (you do not add trademark "®" when using the POM acronym)Use fonts and font sizes that are accessibleInclude a slide/note that "This training is developed using CQL proprietary information, with permission from CQL."Use only images, graphics, quotes, ideas, etc. with the proper licensing rights / copyright permissions.Provide citation/attribution for images, graphics, quotes, ideas, etc. as needed and required.Only use the CQL PowerPoint template for slides created by CQL, which are found in the POM Workshop PowerPoint. (eg - don't include external, non-CQL content on slides with CQL logo/branding)
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Trainer Certification - Customized Training Submission

Certified Trainer Information

Training Content

Submission Checklist