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					Vocational Rehabilitation Association of Canada




 Registered Rehabilitation Professional (RRP )

                     Application Forms




              Vocational Rehabilitation Association of Canada
             4 Cataraqui Street, Suite 310, Kingston, ON K7K 1Z7
         Telephone: 613-507-5530 or 416-494-4700 or 1-888-876-9992
                             Fax: 1-888-441-8002
                         E-mail: info@vracanada.com

                       www.vracanada.com
                        Registered Rehabilitation Professional
                                  APPLICATION FORM
                                            (Please Print)

Name:     ________________________________________________________________________
          (As will officially appear)

Address: ________________________________________________________________________
         (Primary address for correspondence)

City: ______________________ Province:      _______________ Postal Code:      _______________

Telephone: _________________________________ Fax: _______________________________

E-mail: _________________________________________________________________________


Current Employer:

Name of Company: ________________________________________________________________

Your Current Position: _____________________________________________________________

Telephone: ______________________________            Fax: ________________________________

E-mail: ___________________________________________________________________________


Statement of Understanding
I hereby guarantee that the information submitted for this RRP application accurately documents my
education and employment experience. I understand that providing false information will result in
immediate withdrawal of my RRP designation. I have read the VRA Canada Code of Ethics and agree
to abide by these standards while providing rehabilitation services.

_______________________________________________________
Signature of Applicant


_______________________________________________________
Date


Members, who are granted the RRP status must remain members in good standing with the Association,
adhere to the Association’s Code of Ethics and submit proof of 100 approved Continuing Education Units
(CEU’s) over a five (5) year period.

Membership is renewed annually and is valid January to December of each year. Membership must be
renewed each year to validate the RRP . In the event membership with VRA Canada lapses, the RRP
will become invalid.




RRP Application Forms
                                                        Education Information
 Official academic transcripts must accompany the application and must demonstrate successful completion of the program. A transcript will be
                            considered official only if it bears the seal of the university and the signature of the registrar.

                        College Or University                 Dates Of                   Did You                    Degree
                              Attended                       Attendance                 Graduate?                  Achieved

                                                     From:
Undergraduate       University: _________________                                        Yes            Degree:
Degree                                               Mon: _________________
                    __________________________       Year: _________________             No             __________________
                    City: ______________________     To:                            Date of              Major:
                                                                                    Graduation:
                    Prov: ______________________     Mon: _________________                              ______________________
                                                                                    _____________
                                                     Year: _________________

                                                     From:
Graduate            University: _________________                                        Yes            Degree:
Degree                                               Mon: _________________
                    __________________________                                           No             ______________________
                                                     Year: _________________
                    City: ______________________                                    Date of              Major:
                                                     To:                            Graduation:
                    Prov: ______________________                                                         ______________________
                                                     Mon: _________________         _____________

                                                     Year: _________________

                                                     From:
Doctoral            University: _________________                                        Yes            Degree:
Degree                                               Mon: _________________
                    __________________________                                           No             ______________________
                                                     Year: _________________
                    City: ______________________                                    Date of              Major:
                                                     To:                            Graduation:
                    Prov: ______________________                                                         ______________________
                                                     Mon: _________________         _____________

                                                     Year: _________________


RRP Application Forms                                                                                                                       3
Academic Core Competencies

It is the responsibility of the applicant to indicate which courses have been completed to fulfill the academic core competencies. Refer to the core
competency description outlines on pages 3 and 4 of the application guide. Courses may have been taken as part of the degree program or
external to the degree and must be a half-credit (minimum 20 hour) course, accompanied by a course description or syllabus for each course, to
enable the Registration Review Committee to review the course content.

Field Study/Experience, which is a required component to achieve the undergraduate degree, is not eligible as a core competency course.
Workshops, seminars and conferences are not eligible as a core competency as there is no measurable outcome.




     Core Competency Courses                                       Course Taken Which Would Provide Equivalency

Assessment Approaches


Disabling Conditions and/ or
Disadvantaged Groups


Interventions and Strategies


Values, History and Systems
Related to Human Services


Professional Ethics


Communication/Helping/
Interviewing Skills




RRP Application Forms                                                                                                                              4
Employment Information


A:      Current Employer
        A copy of the current job description must accompany the registration application.


Name of Company

Type of Company/Agency
(Please be specific)

Address
City and Province
Postal Code

Telephone Number

Name and Title of Supervisor

Your Position or Business Title

Dates of Employment                  From: ______________________ (Month and Year)

                                     To:    ______________________ (Month and Year)


Are you self-employed?                Yes  No

Do you work full-time or part-       Full-time:  Yes  No      Hours per week: ____________
time?
                                     Part-time:  Yes  No       Hours per week: ____________


Persons Receiving Services
Specify disability/disadvantage

                                      Counselling
After reviewing the Qualifying         Vocational Counselling
Areas of Employment, which             Affective Adjustment Counselling
category(s) would best describe
                                     Assessment
the responsibilities of this
position?                             Vocational Evaluation and Work Adjustment
                                      Job Placement/Development
                                      Job Analysis and Evaluation
                                      Case Management/Rehabilitation Services Coordination
                                      Planning and Reviewing, Monitoring and
                                       Evaluating Programs and Services
                                      Education and Research
                                     Director/Manager/Supervisor




RRP Application Forms                                                                           5
B:      Previous Employer



Name of Company

Type of Company/Agency
(Please be specific)

Address
City and Province
Postal Code

Telephone Number

Name and Title of Supervisor

Your Position or Business Title

Dates of Employment               From: ______________________ (Month and Year)

                                  To:   ______________________ (Month and Year)


Are you self-employed?             Yes  No


Do you work full-time or part-    Full-time:  Yes  No   Hours per week: ____________
time?
                                  Part-time:  Yes  No    Hours per week: ____________


Persons Receiving Services
Specify disability/disadvantage

                                   Counselling
After reviewing the Qualifying      Vocational Counselling
Areas of Employment, which          Affective Adjustment Counselling
category(s) would best describe
                                  Assessment
the responsibilities of this
position?                          Vocational Evaluation and Work Adjustment
                                   Job Placement/Development
                                   Job Analysis and Evaluation
                                   Case Management/Rehabilitation Services Coordination
                                   Planning and Reviewing, Monitoring and
                                    Evaluating Programs and Services
                                   Education and Research
                                  Director/Manager/Supervisor




RRP Application Forms                                                                      6
C:      Previous Employer



Name of Company

Type of Company/Agency
(Please be specific)

Address
City and Province
Postal Code

Telephone Number

Name and Title of Supervisor

Your Position or Business Title

Dates of Employment               From: ______________________ (Month and Year)

                                  To:   ______________________ (Month and Year)


Are you self-employed?             Yes  No


Do you work full-time or part-    Full-time:  Yes  No   Hours per week: ____________
time?
                                  Part-time:  Yes  No    Hours per week: ____________


Persons Receiving Services
Specify disability/disadvantage

                                   Counselling
After reviewing the Qualifying      Vocational Counselling
Areas of Employment, which          Affective Adjustment Counselling
category(s) would best describe
                                  Assessment
the responsibilities of this
position?                          Vocational Evaluation and Work Adjustment
                                   Job Placement/Development
                                   Job Analysis and Evaluation
                                   Case Management/Rehabilitation Services Coordination
                                   Planning and Reviewing, Monitoring and
                                    Evaluating Programs and Services
                                   Education and Research
                                  Director/Manager/Supervisor




RRP Application Forms                                                                      7
D:      Previous Employer



Name of Company

Type of Company/Agency
(Please be specific)

Address
City and Province
Postal Code

Telephone Number

Name and Title of Supervisor

Your Position or Business Title

Dates of Employment               From: ______________________ (Month and Year)

                                  To:   ______________________ (Month and Year)


Are you self-employed?             Yes  No


Do you work full-time or part-    Full-time:  Yes  No   Hours per week: ____________
time?
                                  Part-time:  Yes  No    Hours per week: ____________


Persons Receiving Services
Specify disability/disadvantage

                                   Counselling
After reviewing the Qualifying      Vocational Counselling
Areas of Employment, which          Affective Adjustment Counselling
category(s) would best describe
                                  Assessment
the responsibilities of this
position?                          Vocational Evaluation and Work Adjustment
                                   Job Placement/Development
                                   Job Analysis and Evaluation
                                   Case Management/Rehabilitation Services Coordination
                                   Planning and Reviewing, Monitoring and
                                    Evaluating Programs and Services
                                   Education and Research
                                  Director/Manager/Supervisor




RRP Application Forms                                                                      8
CHECKLIST
Did you remember to include everything?

Before submitting your application, please ensure the following requirements have been fulfilled, as only
fully completed applications will be submitted to the National Registration Review Committee.
Applications still uncompleted after one year from the date of submission will be removed from the active
file and a new application must be resubmitted along with the application fee under the current guidelines
of application.

 Applicant must be a member of VRA Canada
    An application for membership with VRA Canada must be approved before an application for the
    RRP can be submitted to the National Registration Review Committee. The membership and RRP
    applications may be made at the same time, but the RRP application will not be submitted to the
    Review Committee until the membership application has been approved and the required
    membership fee has been paid.

 RRP Application Form
    Please ensure the application form has been completed fully and the Statement of Understanding has
    been read and signed.

 Education Information
    Official academic transcripts have been attached or submitted (photocopies will not be accepted).

 Academic Core Competencies
    Complete the required form to indicate courses taken which would fulfill the academic core
    competencies. A catalogue course description or course syllabus for each course has been
    attached to enable the Registration Review Committee to review the applicable courses and ensure
    the academic core competencies are met.

 Employment Information
    Applicants’ working within a clearly defined employment position in the public or private sector, a copy
    of the current job description has been included with application. Applicants, who are self-employed,
    have included a detailed current resume.

 Reference Forms
    Two (2) references - 1 from a manager, 1 from a professional, are required on the reference forms
    provided. The original copies of the reference forms have been included or submitted (faxed copies
    are not acceptable). References must be current e.g., dated within a year of the RRP application.
    These forms can be submitted directly to the National Office along with the Confirmation of
    Employment Form.

 Application Fee
    The application fee of $131.25 (AB, SK, MB, QC, PE; 5% GST included) or $140.00 (BC; 12% HST
    included) or $141.25 (ON, NB, NS, NL; 13% HST included) has been enclosed. This fee is non-
    refundable. Please make cheque payable to VRA Canada or submit your credit card number (Visa,
    MasterCard) including the expiry date.

    Card Number:        ________________________________               Expiry Date: _______________

                               Please submit the completed application to:

                                                VRA Canada
                            4 Cataraqui Street, Suite 310, Kingston, ON K7K 1Z7
                        Telephone: 613-507-5530 or 416-494-4700 or 1-888-876-9992
                             Fax: 1-888-441-8002 | Email: info@vracanada.com
                                         www.vracanada.com

RRP Application Forms                                                                                     9

				
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