Registration Form

New Jersey Association of School Social Workers
54th Annual Spring Institute
School Social Workers: Promoting Academic Progress
Monday, May 18th, 2015
Renaissance Woodbridge Hotel
515 US Hwy 1 South, Iselin, NJ, 08830, US
NJASSW: $ 95.00
Student/Retiree: $ 85.00
Non-Member: $125.00
Approved Student Volunteer $ 50.00
NAME: _______________________________
HOME ADDRESS: _______________________________
HOME PHONE: _______________________________
OFFICE PHONE: _______________________________
SCHOOL DISTRICT: _______________________________
E MAIL: _______________________________
METHOD OF PAYMENT: _______________________P.O.: _____ Check: ____
___ Tilapia ___Chicken ___Vegetarian Pasta
Work Shop Options
Workshop 1
Workshop 4
Workshop 2
Workshop 5*
Workshop 3
Workshop 6
* Indicates Clinical CEU’s
5 Continuing Education Credits/Hours
Kindly return registration with payment by May 12, 2015 to:
Participant will be responsible for registration fees, if PO is not received and approved.
c/o R. Dawn Clarke
119 Tooker Avenue, Springfield, New Jersey, 07081
Phone: 973-379-4520 Fax: 973-379-4520
Email: [email protected]
Note: If your District pays by purchase order, to ensure that you are pre-registered, please mail a copy of your
registration form noting that the PO will follow, to above address.
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The New Jersey Association of School Social Workers, an approved provider, has approved this program for 5
Professional Development Hours and/or 3 Clinical Continuing Education Units (N.J.A.C.13:44G-6) according
to the regulatory criteria established by the New Jersey Board of Social Work Examiners for the period
September 1, 2014 to August 31, 2016.
8:00 – Registration and breakfast
9:00 – Opening Remarks
Dr. Maurice Elias: * Advocating for Student Growth
MORNING SESSIONS: ( 10:00 to 12:00)
Workshop 1: How to Avoid Litigation
Presenter: Athina Lekas Cornell JD.
Description: Proper record keeping is very important to the work we do. Many cases have been lost because of
poor record keeping or the lack of documentation. This Workshop will address key points for proper
documentation and record keeping in both General Education and Special Education. It will also cover key
parts of an IEP that are important when a case goes to court.
Workshop 2: What You Need to Know to Add Assistive Technology to Your Student’s IEP
Presenter: Brian S. Friedlander, PhD
Description: In this workshop we will review rules and regulations that pertain to assistive technology and
what to consider when doing an assistive technology evaluation and making recommendations in the
students’ I.E.P. We will look at a range of affordable assistive technology tools and solutions that can be easily
integrated into the I.E.P. Lastly, we will discuss best practices with regards to purchasing and implementing
assistive technology.
Workshop 3: Transitioning from Early Intervention System to Preschool
Presenter: Melanie Fleming, MEd; Marguerite Manaresi, MS, EdD; & Patty Green LCSW
Description: Two systems with a common goal of helping the child: transitioning from Early Intervention
System into Preschool. We will be looking at assuring that children receiving early intervention who are
eligible for special education and related services have an Individualized Educational Plan / Program by the
age of three. We will look at aligning practices to comply with an evidence – based framework for transition,
as well as discussing required meetings and timelines under Part B and Part C of IDEA and other relevant
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12:10- Lunch and Presentations
AFTERNOON SESSION: ( 1:15 to 3:15)
Workshop 4: Central Auditory Processing Inside and Outside the Classroom.
Presenter: Carol Anne Ukstins, MS, CCC-A, FAAA
Description: This Workshop will explore the signs and symptoms of (Central) Auditory Processing Disorder
and how (C)APD manifests itself in the classroom performance, as well as at home. A review of interventions
and resources as well as current research in the field will be discussed to help in the identification and
management of (C)APD.
Workshop 5*: Looking at Test Taking and Student Anxiety
Presenter: Colleen Daly Martinez, PhD, LCSW
This workshop will explore test taking and the resulting anxiety on our students. Additionally, the
workshop will explore interventions and strategies to decrease the impact of test taking anxiety for our
Workshop 6: Conducting Effective School Social Work Assessments
Presenter: R. Dawn Clarke, MSW , LCSW
Description: This workshop will identify the most effective tools, techniques and methods to use in collecting
data; discuss the process of deriving significant and appropriate educational determinations and then how to
incorporate those findings into a focused report.
Renaissance Woodbridge Hotel, address: 515 US Highway 1 South, Iselin, NJ. 08830
Directions from the North:
Take the Garden State Parkway South to exit 130. Merge onto U.S. 1 N towards Newark. Continue on U.S. 1
North to Gill Lane. Take the Gill Lane exit. Keep right and merge onto Woodbridge Center Drive. Take the 1st
left onto U.S. 1 S towards Princeton. Make a right into Renaissance Woodbridge Hotel driveway.
Directions from the South:
New Jersey Turnpike North. Continue on Turnpike North to Exit 10. Merge on to I-287 North, then merge on
to U. S. 1 north, Exit 1A towards Newark. Continue on U.S. 1 North to Gill Lane. Take the Gill Lane exit. Keep
right and merge onto Woodbridge Center Drive. Take the 1st left onto U.S. 1 S towards Princeton.
Make a right into Renaissance Woodbridge Hotel driveway.
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Student Volunteer Application
The New Jersey Association of School Social Workers is seeking STUDENT VOLUNTEERS to assist the
Programing Committee in our Annual Spring Institute. We are hoping to engage and empower Social Work
Students through service to this Association to enhance their overall education and unique ability to engage
with seasoned Social Workers already in the field.
Why join a Professional Association like New Jersey Association of School Social Workers? We are a group of
professionals within the field who come together for:
· Individual professional development and advancement
Promoting the field and educating the public on issues related to the profession
Networking and collaborating
Sharing new ideas and practices that set standards for the profession and workplace
Representing interests of the profession before federal, state and local governments
First Name: _______________________________ Last Name: _______________________________
Street Address: __________________________________________________________________________
City: ________________State: ________________ Zip: ________________
Email Address: _______________________________
Home Phone Number: _________________________ Cell Phone Number: ________________________
Emergency Contact Name and Number: _____________________________________________________
Have you been convicted of, or pleaded no contest to, a felony within the last five years? Yes * No *
If yes, please explain (attach additional sheets if necessary):____________________ _
School Name: _________________________________________________________________
City, State: ____________________________________________________________________
Degree/Diploma: __________________________ Graduation Date: _____________________
Are you bilingual? _________________ If yes, what language? __________________________________
Please list any other skills, licenses, certifications, training, awards, etc.
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