ÐÏà¡±á>þÿ =@þÿÿÿ:;<ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Ás ð¿6bjbj|]|] î]7ij7ijØ-+ÿÿÿÿÿÿ·BB; ; ; ; ; ÿÿÿÿO O O 8‡ ´;"lO Zæ§$^%%%%;'>y''ýœÿœÿœÿœÿœÿœÿœ@ ¶ö¢zÿœ; ™''";'™'™'ÿœ; ; %%þO*O*O*™'”; %; %ýœO*™'ýœO*O*š‰L’%ÿÿÿÿð¥ï&.ÀÛÿÿÿÿ-(jcŒZéœ*0Z½ŒFp£—(Ðp£´’’Rp£; U“” ™'™'O*™'™'™'™'™'ÿœÿœg)è™'™'™'Z™'™'™'™'ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿp£™'™'™'™'™'™'™'™'™'B¿: SOCIAL WORK CPD MODULE APPLICATION FORM 2025/26 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. 905L6AutumnWork-based Research Supervision with some on Campus29 Aug 202545 884L5AAutumnDissertationSupervision29 Aug 202560 881L5AutumnRisk & Decision-Making: Challenges for Children’s Services Management & Practice Online29 Aug 202530 9601SAutumnProfessional Learning ReviewSupervision29 Aug 202515899L6Autumn Practice Education 2 (30c) On Campus29 Aug 202530899L6BAutumn Practice Education 2 (15c) On Campus29 Aug 202515914L6Autumn Developing Innovation in Social Work & Social Care OrganisationsOnline29 Aug 2025309700AAutumnWorking with Young People at Complex Safeguarding Risk On Campus29 Aug 202530886L5SpringPractitioner ResearchOn Campus5 Dec 202515903L8SpringProfessional Learning Review Extended (30 credit version of module)Supervision5 Dec 202530904L6SpringObserving, Communicating & Engaging with Children & Young PeopleOn Campus 5 Dec 202530 APPLICATION GUIDELINES 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): ÈÕº«ÎÞÂë 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. If you have completed a Work History for a CPD application in the last 3 years, please list your current job role only. Date From MM/YY – MM/YYJob role and key tasks academic qualifications Title Awarding BodyAward level/ClassWhere 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 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 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 Sussex 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 select either A) or B) My attendance on this course is nominated and funded by my Local Authority/Employer. Please send to your completed form to your Practice Education/ Training Manager to be checked, signed, and sent to the University. Complete Appendix 1 I am self-funded. Please send your completed form directly to HYPERLINK "mailto:pqcoord@sussex.ac.uk"pqcoord@sussex.ac.uk Fees are payable after the first day of teaching and will be charged to your Sussex Direct University Account. (Complete Appendix 2) For all CPD enquiries contact: Susana Vazquez Coordinator, Social Work Continuing Professional Development (CPD) School of Education & Social Work Department of Social Work & Social Care ÈÕº«ÎÞÂë Brighton BN1 9QQ T 01273 872733 E HYPERLINK "mailto:pqcoord@sussex.ac.uk"pqcoord@sussex.ac.uk W 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 LOCAL AUTHORITY/EMPLOYER 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: Practice/Training Manager’s email: _______________________________________ INVOICING DETAILS: Contact details for person to receive invoice: (For students from Brighton and Hove City Council, East Sussex County Council & West Sussex County Council this can be left blank.) Name Position 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 after the first day of teaching. Unless advised otherwise, these fees will charged to my University Sussex Direct Account. Am expected to attend at least 80% of teaching for any module and will advise my convenor or coordinator if I am unable to attend. Understand that fees are non-refundable after the first day of teaching. If I am unable to attend the course, I will contact the CPD Coordinator to arrange temporary withdrawal and a suitable return date. 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 (To be completed by candidate & manager) Applicants for PE2 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 2) I confirm that I am a registered social worker and have included my Social Work England registration number in this application Stage 2) I confirm that I have achieved Practice Education Stage 1 or equivalent (please give details) 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. Manager’s Name: Manager’s Signature: Date: End. 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