For the purpose of documenting education requirements described in Alc 307.03 for LADC and Alc 310.03 for MLADC, applicants shall submit an “Education and Training Summary Form” which contains the following information:

1. (a) For the required minimum 6 hours of training in ethics, suicide prevention, confidentiality, the 12 core functions, and HIV and AIDS, the following information:

   1. (1) The date(s) the applicant attended the training(s);
   2. (2) The agency or agencies which sponsored the training(s);
   3. (3) The categories of competence, outlined in Alc 313.10(j), covered by the training; and
   4. (4) The total number of hours of training accumulated in each related training; and

2. (b) For each training undertaken to satisfy the remaining 270 hours of required education:

   1. (1) The title of the course or training;
   2. (2) The dates of attendance;
   3. (3) The sponsoring agency;
   4. (4) The categories of competence, outlined in Alc 313.10(j), covered by the training; and
   5. (5) The total number of training contact hours;

3. (c) For each training described in Alc 313.11(b), a copy of the certificate of attendance, to which the applicant shall:

   1. (1) Assign an item number that corresponds to the respective title of course on the “Education and Training Summary [Report] Form”; and
   2. (2) Attach to the ”Education and Training Summary Form” in numerical order; and
4. (d) For each training described in Alc 313.11(c) that has not been pre-approved by the board, a description or outline of the training to accompany the certificate described in part (d) of this section, including a syllabus or brochure for the program and a description of the category or categories of competence covered by the training.

Source. #12001, eff 10-13-16; ss by #13518, eff 3-13-23 (formerly Alc 313.11) (see Revision Note for chapter heading for Alc 300)