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To be enrolled to take online classes at, you will need to be registered for Encompass, our organization's database to track and report trainings in Child Welfare held across PA. Here you can fill out the demographics form and submit to send this electronically to our staff.

If you are a Foster Parent/Resource Parents, please use the Resource Parent Version of the form. Since you do not work for a county or private provider, you will not have to fill in as many fields of a data.

Date Completed:
Work Phone:
Birth Date:
Gender: Male Female
County of Employment:
Agency Name:
Black/African American
American Indian/Alaskan Native
Native Hawaiian/Pacific Islander
2 or More

Are you able to provide services to children/families in a language other than English?

Yes    No
Current Highest Educational Degree:
Less Than High School
High School Diploma or GED
Associates degree (indicate Major Code)
Bachelor's degree in Social Work
Bachelor's Degree - other: (indicate Major Code)
Master's degree in Social Work
Master's Degree - other: (indicate Major Code)
Doctoral Degree
Current Education:

Are you currently a BSW or MSW student?
Yes No

If Yes,
Are you a current CWEB student? Yes No
Are you a current CWEL student? Yes No

Are you currently pursuing an additional degree or certificate other than a BSW or MSW? Yes No

If Yes, in what? (indicate Major Code)

Are you a current CWEB graduate? Yes No

Are you a current CWEL graduate? Yes No

Current Employment: Current Job Title: (indicate Job Code)

Effective Date:

As part of your day-to-day work, do you provide supervision to other staff?
Yes No

Agency type:
Public Child Welfare

Primary Work Unit (please choose one):

Intake (Screening, Intake Assessment)
Investigation/Assessment (CPS, GPS)
Independent Living
Non direct service (Clerical, Fiscal, Business)
School Based
Ongoing (In-home, Family Preservation)
Substitute Care (Out of home placement, foster care)
Administrative (Manager, Director/Assistant, Administrator/Assistant, Program Specialist, Contract Monitor)
Other direct service (Homemaker, Case-aid, Family Group
Generic Unit (agency does not have distinct work units)

In a "typical" month, how many families and how many children are you responsible for managing?
No caseload (N/A)

# of Families

# of Children


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