Grandfathered SFW Application


Last Name:  ______________________________

First Name: ________________________       Middle Name/Initial:  ________________

Address:  __________________________________________________________________

Address2: _________________________________________________________________

City/State/ Zip Code:  ________________________________________________________

Phone #:  __________________________________

D.O.B.: ________________________ Gender (M/F):  ______________

Email Address:  _______________________________________________________

Current Employment:  __________________________________________________

# of Years in Position:  ___________________

Work Address:  ______________________________________________________________________

Work City/State/Zip:  __________________________________________________________________

Year Earned FDC:  ________________    State Earned FDC: ______________

Agency that provided training:  __________________________________________________

FDC Instructor Name: ___________________________________________________

Use FDC Concepts in Current Job?  (Y/N):________________________

Highest Education Level Completed:  _____________________________

Completed FDLC (Y/N): ________________  Year Completed FDLC: ________________

Completed Instructor’s Institute Y/N:_____________  Year Completed: __________________

Year last served as an instructor for FDC class: _______________

Completed Portfolio Adviser (Y/N):_______________ Year Completed: __________________

Year last served as an Adviser for FDC class: ______________

How should your full name appear on the Credential?

________________________________________________________


Download the Application

In order to receive the SFW credential you must have earned your FDC credential previously.

Please submit the application along with a $10 fee for processing to:

Temple University – Harrisburg Campus
234 Strawberry Square
Harrisburg, PA  17101
Attn.:  Amy Garvey

Please make the check or money order out to Temple University

If you have any questions you may contact Amy Garvey at (717) 232-6400 x441 or at amy.garvey@temple.edu