ÐÏà¡±á>þÿ 9<þÿÿÿ678ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Á[ ð¿C:bjbjXX îg:j²i:j²i2+ÿÿÿÿÿÿ·’’’’’ÿÿÿÿ¦¦¦8Þœz!œ¦êˆ²$^t$Š$Š$Š$ª&Nø&'iˆkˆkˆkˆkˆkˆkˆ$œ‹¶RŽxˆ’$'ˆ&"ª&$'$'ˆ’’Š$Š$þ¤ˆP)P)P)$'R’Š$’Š$iˆP)$'iˆP)P)ÖwÀg~Š$ÿÿÿÿÀ‘m‰‘Úÿÿÿÿv'²ßyLUˆºˆ0êˆ+z<ÊŽ((ˆÊŽ˜g~g~RÊŽ’¹œ$'$'P)$'$'$'$'$'ˆˆ°( $'$'$'êˆ$'$'$'$'ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÊŽ$'$'$'$'$'$'$'$'$'XX: SOCIAL WORK CPD MODULE APPLICATION FORM 2024/25: New Students NameJob title PLEASE STATE MODULE/S FOR WHICH YOU ARE APPLYING (for this academic year only) Enter tick or ‘x’ in module(s) selected column. Module codeTermModule NameDeliveryApplication cut off CreditsModule(s) selectedTIP (15 credit)Autumn/ SpringUnderstanding & Engaging in Trauma Informed Practice.OnlinePlease contact your Training Manager for details on how to apply for this module. 886L5AutumnPractitioner ResearchOn Campus2 Sept 202415 884L5AAutumnDissertationSupervision2 Sept 202460 881L5AutumnRisk & Decision-Making: Challenges for Children’s Services Management & Practice Online2 Sept 202430 9601SAutumnProfessional Learning ReviewSupervision2 Sept 202415899L9Autumn Practice Education 1&2 combined (Online)Online2 Sept 202430899L6Autumn Practice Education 2 (30c) On Campus23 Aug 202430899L6BAutumn Practice Education 2 (15c) On Campus23 Aug 202415914L6Autumn Developing Innovation in Social Work & Social Care OrganisationsOnline2 Sept 2024309700AAutumnWorking with Young People at Complex Safeguarding Risk On Campus2 Sept 2024309300LSpringPromoting Anti-Oppressive Practice On Campus2 Sept 202430903L8SpringProfessional Learning Review Extended (30 credit version of module)Supervision2 Dec 202430905L6SpringWork-based Research Supervision with some on Campus2 Dec 202445 APPLICATION GUIDELINES * Note that the modules listed as ‘Level 6’ will enable students to take the module at an undergraduate level rather than a postgraduate level. Whilst students will receive the same taught content, the module assessment will be tailored to meet year 3 undergraduate standards rather than postgraduate standards. Please use this CPD Module Application Form for ALL CPD modules except ‘Understanding & Engaging with Trauma Informed Practice’. For this module only, you should contact your Training Manager for details on how to apply. if you are applying for a research-based module (dissertation, practitioner research or work based research) please outline any research AREAS/ideas THAT YOU WOULD BE INTERESTED TO develop in your studies PLEASE GIVE DETAILS HERE OF ANY PRIOR STUDY/CPD MODULES TAKEN AT THE uNIVERSITY OF SUSSEX IN THE LAST 5 YEARS (this will help us to advise on any prior learning that could be brought to the new award – Pg certificate, pg diploma or ma) eligibility for application to programme: Please GIVE DETAILSI hold a professional or vocational qualification (NVQ level 5 or above) and work in Children’s or Adults’ Services, health, education or social care. I am employed or am undertaking voluntary work within Children’s or Adult Services, health, education or social care for at least 15 hours a week. PERSONAL DETAILS Surname: Title:Date of Birth: First Names: Previous Surname(s) (if applicable): Home Address: Post Code:Work Address: Post Code:Mobile No: Daytime Telephone No: Personal email address Work E-mail Address: Nationality (as on passport) Country of Birth:Gender:Pronoun:Next of Kin Name:Next of Kin Emergency Contact No: WORK HISTORY: Please detail your current and past job roles starting with the most recent. Date From MM/YY – MM/YYJob role and key tasks academic qualifications Title Awarding BodyAward levelWhere gainedYear gained professional or vocational qualificationS – please list highest qualification first Title Awarding BodyWhere gainedYear gained IF YOU ARE APPLYING FOR Practice education stage 2 or the combined Practice Education stage 1&2 module, PLEASE ENTER YOUR social work england number IN THE BOX BELOW please ALSO complete appEndix 3 if you are applying for Practice education stage 2 or PRACTICE EDUCATION STAGE 1&2 COMBINED DISABILITY and specific Learning Needs We encourage you to disclose any disability or medical condition which may affect your future studies. All offers are made on academic grounds and the information given here will be used to help provide services which meet your needs. Please tick box. No disability Neurodivergent – Autism/ADHD/Dyslexia/Dyspraxia/DyscalculiaBlind/serious visual impairment Deaf/Serious hearing impairment Long standing illness/condition Mental health condition Physical impairment/mobility issue Disability not listed Two or more impairments or disabling conditions Other (please specify) OR additional information which may help us to support you. I consent to this information being shared with the Student Support Unit 9.ETHNICITY To assist us with our confidential monitoring please choose one selection from A-E to indicate your ethnic group. Please tick box. White: British Asian or Asian British: Indian IrishAsian or Asian British: PakistaniAny other white backgroundAsian or Asian British: BangladeshiMixed: White and Black Caribbean Any other Asian backgroundMixed: White and Black AfricanBlack or Black British: CaribbeanAny other Mixed background Black or Black British: AfricanChineseAny other Black backgroundGypsy or Irish TravellerArabRomaOther MODULES ON THIS COURSE REQUIRE YOU TO HAVE ACCESS TO A WORK ENVIRONMENT (VOLUNTARY OR PAID EMPLOYMENT). PLEASE GIVE DETAILS: Name:Address: Telephone NumberJob Title: E-mail Address: CANDIDATE’S AGREEMENT I declare that the information I have provided is true. I acknowledge that my acceptance of a place at ÐÔ°®ÊÓÆµ University is subject to the University’s terms and conditions and agree to abide by any University laws that are in place during my period of study. The terms and conditions that apply to this agreement can be viewed online at: HYPERLINK "http://www.sussex.ac.uk/termsandconditions" www.sussex.ac.uk/termsandconditions and you are advised to read these before signing the agreement. Data Protection Declaration Please note that the personal data captured on this form will be processed in accordance with the General Data Protection Regulation; for more information about how the University processes personal data and your rights, please visit our privacy notice: HYPERLINK "http://www.sussex.ac.uk/about/website/privacy-and-cookies/privacy" http://www.sussex.ac.uk/about/website/privacy-and-cookies/privacy. Applicant’s signature: Date: FUNDING please tick either a) or b) a) My attendance on this course is nominated and funded by my employing agency (please complete appendix 1)b) I am self-funded (please complete appendix 2) If self-funding Please complete Appendix 2 and email your application directly to HYPERLINK "mailto:pqcoord@sussex.ac.uk" pqcoord@sussex.ac.uk If agency / employer funded Please send to your completed form to your Training Manager to be checked, signed, and sent to the University. For admissions enquiries contact: Susana Vazquez Coordinator, Social Work Continuing Professional Development (CPD) School of Education & Social Work Department of Social Work & Social Care ÐÔ°®ÊÓÆµ Brighton BN1 9QQ 01273 872733 HYPERLINK "mailto:pqcoord@sussex.ac.uk" pqcoord@sussex.ac.uk HYPERLINK "http://www.sussex.ac.uk/schools/education-and-social-work/study/social-work/cpd"www.sussex.ac.uk/schools/education-and-social-work/study/social-work/cpd Appendix 1 AGENCY AGREEMENT IN SUPPORT OF APPLICATION FOR POSTGRADUATE STUDY AT THE UNIVERSITY OF SUSSEX (To be completed by candidate’s Designated Training Manager within the employing agency) We, the employing agency (name) __________________________________________ Hereby nominate (candidate’s name) __________________________________ To attend the following course _______________________________________ We agree to the payment of course fees. We agree that the agency will provide appropriate professional opportunities to assist the candidate in assignment work. We agree that the required time will be made available for the candidate to attend the course and to undertake study and assignment work, as specified in the course handbook and timetable. It is our considered view that the candidate meets the entry requirements for this course. It is our considered view that the candidate has the ability and commitment to complete the required course work. Designated Training Manager in the employing agency/authorised person: Name: Post: Signature: Date: Training Manager’s email: _______________________________________ INVOICING DETAILS Contact details for person to receive invoice: (For students from Brighton and Hove City Council, East ÐÔ°®ÊÓÆµ County Council and West ÐÔ°®ÊÓÆµ County Council this can be left blank.) Name__________________________________________________________ Address ________________________________________________________ _______________________________________________________________ Phone number___________________________________________________ Appendix 2 SELF FUNDING AGREEMENT IN SUPPORT OF APPLICATION FOR POSTGRADUATE STUDY AT THE UNIVERSITY OF SUSSEX (To be completed by candidate) Course applied for_________________________________________________________ I, (student’s name) ____________________________________________________ Agree to the payment of course fees in full on registration to the module. Agree that my agency/employer will provide appropriate professional opportunities to assist in my assignment work. Agree that I have arranged for the required time will be made available for me to attend the course and to undertake study and assignment work, as specified in the course handbook and timetable. Have read and understood the course requirements and consider myself eligible to take park in the course/s I have specified. Am aware of the time and commitment this course requires and agree I have set aside both to complete the module to the best of my ability. Name: ______________________________________________________________ Signature: ___________________________________________________________ Date: _______________________________________________________________ Appendix 3 ADDITIONAL INFORMATION REQUIRED IF APPLYING FOR PRACTICE EDUCATION STAGE 2 OR STAGE 1&2 COMBINED (To be completed by candidate & manager) STAGE 2 Applicants must: Be a registered social worker. Have previously had some responsibility for the teaching and assessment of a trainee social worker or other social work learner. Agree to have primary responsibility for the teaching and assessment of a trainee social worker during the course of study. Have achieved Practice Education Stage 1 or equivalent with evidence of currency. STAGE 1&2 COMBINED Applicants must: Be a registered social worker. have a minimum of two years' post qualifying social work experience. Have had some previous experiences of supervising a social work learner (I.e., trainee social worker, newly qualified social worker or other social work staff. Agree to have primary responsibility for the teaching and assessing of a trainee social worker during the course of study and also take responsibility for an additional teaching, learning or assessment task with a second social work learner Stage 1 & 2) I confirm that at the time of study I will have some responsibility for the teaching and assessment of a trainee social worker or other learner during the course of study.Stage 2) I confirm that I am a registered social worker and have included my Social Work England registration number in this applicationStage 1 & 2) I confirm that I have a minimum of two years' post qualifying social work experience and have included details in this applicationStage 2) I confirm that I have achieved Practice Education Stage 1 or equivalent (please give details)Stage 1 & 2) Please give details of prior experience of supervising social work learners Applicant’s signature: To be completed by applicant’s line manager: Please provide a brief statement to confirm how the trainee practice educator is practising at PCF Experienced Social Worker Level 7 in their role. 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