Continuing Education Completion Verification Form

Name*

First

Last
CVRP Certificate and Number*
Registration Month*
Email*
Phone (home)
Phone(work)*
Employer*
Information Related to Education Session
Title of Education Session*
Sponsor for Education Session*
Sponsor Mailing Address*
Contact Person

First

Last
Sponsor Email*
Sponsor Phone*
Date(s) of Education Session*
Date Completed
CVRP Approval Number*

To get the Approval Number click here
Number of hours approved*
Number of Hours of Attended*
Domain of Learning – Focus Areas*
- 01-Vocational Rehabilitation Theory & Practice
- 02-Aspects of Disabilities – Medical, Functional & Environmental
- 03-Vocational Interviewing & Counselling
- 04-Assessments
- 05-Diversity
- 06-Job Development & Placement
- 07-Case Management/Disability Management
- 08-Ethical & Professional Conduct
- 09-Communication & Record Keeping
- 10-Supervision of Intern Registerant or VR Student
- 11-CVRP Volunteer Credits/Other Volunteer Credits
- 12-Development/Presentation of VR Education/Publication
- 13-Other Professional Development
Education Category
- Conference / Symposium
- Workshop / Seminar
- College Course
- University Course
- On-line Course / Home Study
- Education Presentation at Workplace
- * Develop a Professional Presentation (2 CEU’s per hour of training)
- * Development Hours of In-Service Training (2 CEU’s per hour presentation)
- Publication of VR Research or Peer-Reviewed VR Article
- Editorial Review of a Recognized Vocational or Rehabilitation Counselling Publication
- * Curriculum Development for Vocational Rehabilitation Course
- * Annual Review of Established Curriculum of a VR Program
- * Supervise Fieldwork of Vocational Rehabilitation/Career Counselling Student
- Research – Vocational Rehabilitation and/or Career Counselling/Placement5
- Development of Canadian/Provincial Legislation or Regulation
* Hours for these categories must be outside of usual work tasks if in an employment setting. ie. Activity must not be part of a paid employment function.
Print Name of person verifying attendance

First

Last
Contact email

Please note that continuing education hours will not be accredited until Proof of Attendance or Completion Certificate has been received.

We discourage faxes in an effort to be green.

Please upload an electronic copy below or mail a hard copy
Please upload completion certificate or proof of attendance for hours to be credited

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Continuing Education Completion Verification Form

Information Related to Education Session

Please note that continuing education hours will not be accredited until Proof of Attendance or Completion Certificate has been received.