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					         APPENDIX B: MINNESOTA CHILD WELFARE TRAINING SYSTEM
                TRAINER / WRITER PROPOSAL APPLICATION
Check the contracted position you are applying for.
                                                                              DHS Staff Only: Review Sections
 Trainer Only
                                                                              ___ Trainer Only
                                                                              ___ Writer Only
   (Need a minimum of 5200 points to be eligible to contract for services.)   ___ Both Trainer & Writer

 Curriculum Writer Only
   (Need a minimum of 5760 points to be eligible to contract for services.)

 Both Trainer and Writer
   (Need a minimum of 7040 points to be eligible to contract for services.)

Are you are a Foster, Adoptive or Kinship Provider (FAK)?          Yes            No
An FAK Provider is defined as an individual licensed under Minnesota Statute 2960 to provide foster care.

NOTE: Do not use acronyms unless they are identified prior to use.

GENERAL INFORMATION (All applicants complete this section.)

 Name: (Last, First, Middle initial)

 Mailing Address:                                        Email Address:




 Home Telephone: (       )                               Day Telephone: (      )
 Work Telephone: (       )                               Cell Telephone: (     )
 Fax: (   )                                              Licensure(s):
                                                          Type:
                                                          License Number:
                                                          Expiration Date:

 Language Proficiency:                                   Optional - Please indicate the categories that best
    Hmong                                                describe your racial/ethnic/cultural background:
    Spanish
    Somali
    Other:
                                                           Native American/American Indian
                                                           Multi-racial
                                                         This information is not an evaluation factor




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GENERAL INSTRUCTIONS:
Complete all remaining sections based on the contracted position you are applying for; respond to all narrative
questions clearly and concisely. Clarity, conciseness and content are considered in scoring. If you are both a
Professional and a Provider, you will be scored as a Professional according to the points assigned to each
question.

EDUCATIONAL HISTORY (All applicants complete this section - 1000 points)
List your educational background, beginning with your most recent degree. Insert additional row(s) if necessary.
DO NOT INDICATE “SEE RESUME.” (Possible Points: Professionals 1000 / Providers 1000)

   College/University/High School                Dates Attended                   Degree Earned / Major




EMPLOYMENT HISTORY AND / OR FAK PROVIDER EXPERIENCE
DO NOT INDICATE “SEE RESUME.” (All applicants complete this section – 1000 points)
1. Have you been a foster, adoptive or kinship provider? If yes, how long?
   (Possible Points: Professionals NA / Providers 100)

2. Have you worked in a county or tribe as a child welfare worker? If yes, how long?
   (Possible Points: Professionals 100 / Providers NA)

3. List your employment history and/or FAK provider experience. Begin with your most recent experience.
   Insert additional row(s) if necessary. (Possible Points: Professionals 200 / Providers 300)

Agency:                               Position:                             Dates:
Address:                              Supervisor:
                                      Licensing Worker:
Duties:



Agency:                               Position:                             Dates:
Address:                              Supervisor:
                                      Licensing Worker:
Duties:


Agency:                               Position:                             Dates:
Address:                              Supervisor:
                                      Licensing Worker:
Duties:




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4. Describe your experiences working with or caring for the following populations:
  (Possible Points: Professionals 600 / Providers 600) (Do not exceed 500 words for this question.)

    Children who have been abused or neglected:


    Children with developmental and / or physical disabilities:


    Children with mental health challenges:


    Children and families living in poverty:


5. Describe your experiences supervising staff who work with or care for the following populations:
  (Possible Points: Professionals 100 / Providers NA) (Do not exceed 500 words for this question.)

    Children who have been abused or neglected:


    Children with developmental and / or physical disabilities:


    Children with mental health challenges:


    Children and families living in poverty:


WRITING EXPERIENCE (Complete this section if interested in writing curricula - 1500 points)
1a. Have you written a scripted (detailed, word-for-word) curriculum? Yes  No
  (Possible Points: Professionals 100 / Providers 100)

1b. If yes, list a maximum of 10 curricula topics you have written over the past 5 years. Insert additional rows
    if necessary. (Possible Points: Professionals 50 / Providers 50)

 Date         Curriculum Title                           Length of    Target Audience               If co-
                                                         Training                                   authored,
                                                                                                    how many?




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1. Describe up to three specific examples of how you would incorporate, or have incorporated, culture and
   diversity into curricula. (Possible Points: Professional 250 / Provider 250) (Do not exceed 300 words.)



3. Describe your experience in developing curricula to be delivered by alternative methods such as ITV / VPC
   or e-learning. (Possible Points: Professional 50 / Provider 50)



4. Describe your experience using the following Microsoft Office applications (PowerPoint presentations, MS
   Word, etc.). (Possible Points: Professional 150 / Provider 150)



  Based on your education and / or experience, list the child welfare curricula topics you are interested in
  writing. (Possible Points: Professional 0 / Provider 0)

                                              Child Welfare Areas
   e.g. Concurrent Permanency Planning




5. Attach a curriculum sample, professional / academic writing sample or PowerPoint presentation with trainer
   notes. (Possible Points: Professional 900 / Provider 900)

TRAINING EXPERIENCE (Complete this section if interested in training – 1000 points)
1. What types of training experience do you have?
   Formal Classroom Training Sessions with Developed Curricula for:
   (Possible Points: Professional 250 / Provider 150)

     Small groups (10 or fewer participants)
     Large groups (more than 10 participants)
     Paid presentations to any size group

  Informal Training Sessions without Developed Curricula for:
  (Possible Points: Professional 250 / Provider 300)

     Individuals
     Small groups (10 or fewer participants)
     In-service agency presentations
     Community education, not related to child welfare




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2. List the topics trained over the past 5 years. (Maximum of 10.) Insert additional rows if necessary.
   (Possible Points: Professional 50 / Provider 50)

Date       Title of Training                        Location                  Length of      Target Audience
                                                                              Training




3. Describe up to three specific examples of how you would incorporate, or have incorporated, culture and
   diversity into your training. (Possible Points: Professional 250 / Provider 300) (Do not exceed 300 words.)



Based on your education and / or experience, list the child welfare topics you are interested in training.
(Possible Points: Professional 0 / Provider 0)

                                               Child Welfare Areas
 e.g. Concurrent Permanency Planning




4. Describe your experience in training curricula delivered by alternative methods such as ITV / VPC or
   e-learning. (Possible Points: Professional 50 / Provider 50)



6. Describe your experience in using the following Microsoft Office applications (PowerPoint Presentation,
   MS Word, etc.). (Possible Points: Professional 150 / Provider 150)



CULTURE AND DIVERSITY (All applicants complete this section – 1000 points)
1. What does culture and diversity mean to you? (Possible Points: Professional 200 / Provider 300) (Do not
   exceed 200 words.)



2. Describe specific personal and / or work-related culture and diversity experience(s). How have these
   experiences influenced your growth and development? (Possible Points: Professional 200 / Provider 300)
   (Do not exceed 200 words.)



3. Describe what initiative(s) you have taken to experience other cultures. (Possible Points: Professional 200
   / Provider 300) (Do not exceed 200 words.)

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4. Describe your understanding of tribal sovereignty, Indian Child Welfare Act (ICWA) and Minnesota Indian
   Family Preservation Act (MIFPA). (Possible Points: Professional 200 / Provider NA) (Do not exceed 300
   words.)



5. List the last five culture and diversity trainings you have attended. Include the date and location for each
    course. (Possible Points: Professional 200 / Provider 100)


TRANSFER OF LEARNING (All applicants complete this section – 500 points.)
Transfer of Learning is defined as “the application of new knowledge and skills into practice.” It is an essential
piece of all learning in the MCWTS.

Describe four transfer of learning strategies you have incorporated, or would incorporate, into training(s).
(Possible Points: 125 per answer) (Do not exceed 300 words for all strategies.)
1.

2.

3.

4.

COST PROPOSAL (All applicants complete this section.)
(Possible Points: Trainer Only: 2000 / Writer Only: 2200 / Trainer and Writer: 2800)

Minnesota Statute requires that best-value procurement must include an evaluation of price. The compensation
amounts detailed in Appendix A: MCWTS Trainer and Writer Handbook reflect the STATE’S compensation
for a six-hour training day. Responders are encouraged to submit an alternative lower cost proposal. It is the
STATE’S intention to periodically review all contracts entered into as a result of the RFP and cancel those that
are not cost-competitive.

     I accept the compensation and reimbursement amounts listed in the MCWTS Trainer and Writer Handbook.
     I propose alternative compensation and reimbursement amounts. My proposed alternatives are listed below.




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he compensation and reimbursement amounts listed in the MCWTS Trainer and Writer Handbook.
 I propose alternative compensation and reimbursement amounts. My proposed alternatives are listed below.




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