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NOTE: Please save document to fill in electronically. Five hard copies must be returned by mail, as per instructions below.
NameAddressTelephoneEmailDate Certified
Instructions
Deadline for applications May 30
Requirements for re-certification
WORK EXPERIENCE: Minimum of 100 hours of practice, 20 of which must be demonstrated in Family Education Group Facilitation in the year previous to re-certification
PROFESSIONAL DEVELOPMENT: Minimum of 50 hours of professional development
REFERENCES: Two letters of reference from persons who have direct knowledge and/or experience of your work/activities in this area during this period
Application Package
Five copies of application with any supporting documentation
$40.00 re-certification processing fee (download payment form at HYPERLINK "http://www.frp.ca/CCFE" www.frp.ca/CCFE)
Mail application package with payment to:
Canadian Association of Family Resource Programs (FRP Canada)
707 331 Cooper Street
Ottawa, ON K2P 0G5
Tel: 1-866-637-7886 / (613) 237-7667 Fax: (613) 237-8515 HYPERLINK "mailto:info@frp.ca" info@frp.ca
Work Experience
Please indicate the kinds of Family Education you have provided or been involved in during the past five years. Provide information about your experience in as many different areas as possible. Attach documentation if available. For estimated total hours, do not include prep time.
Note: A minimum of 100 hours of practice is required, 20 of which must be demonstrated in Family Education Group Facilitation in the year previous to re-certification. (Use TAB to create additional lines to each section, if needed.)
Family Education Group Facilitation
(20 hours required in most recent year)Activity and focusDatesOrganizationEstimated
total hours12345678
Training / Teaching / Supervising Other Family EducatorsActivity and focusDatesOrganizationEstimated
total hours1234
Administration of Family Education ProgramsProgram titleDatesOrganizationEstimated
total hours1234
Development of New ProgramsProgram title and focusDatesOrganizationEstimated
total hours1234
Redevelopment of Existing ProgramsProgram title and focusDatesOrganizationEstimated
total hours1234
Presentations on Family Education TopicsTitleDatesOrganizationEstimated
total hours1234
Written Articles / Topic Sheets / HandoutsTitlePublished in / used forEstimated
total hours12345
Other (please describe)
Total Work Experience Hours (minimum of 100 hours required)
Professional Development
How have you stayed current in Family Education during the past five years? Please provide information, in as many of the following as are applicable, detailing the steps you have taken to remain current in the field of family education. If documentation is available, please attach.
Note: A minimum of 50 hours of professional development is required. (Use TAB to create additional lines to each section, if needed.)
Titles of courses / workshopsDatesEstimated
total hours12345678
Please state briefly how this training has influenced your practice of Family Education.
Titles of published material read, critiqued, reviewed, etc.DatesEstimated
total hours123456
Please state briefly how these materials have influenced your practice of Family Education.
Conference or symposia attendedDatesEstimated
total hours1234
Please state briefly how this attendance has influenced your practice of Family Education.
Other comments:
Total Professional Development Hours (minimum of 50 hours required)
I hereby give permission to the Canadian Association of Family Resource programs (FRP Canada) to:
FORMCHECKBOX Publish my name as a Canadian Certified Family Educator
FORMCHECKBOX Share m y e m a i l a d d r e s s w i t h o t h e r C C F E s f o r n e t w o r k i n g p u r p o s e s
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ F O R M T E X T
S i g n a t u r e D a t e
F O R M T E X T
N a m e
R e - C e r t i f i c a t i o n F o r m
C e r t i f i e d C a n a d i a n F a m i l y E d u c a t o r ( C C F E )
C a n a d i a n A ssociation of Family Resource Programs (FRP Canada) 707-331 Cooper St., Ottawa Ontario K1Y 2C1 T: 613-237-7667 F: 613-237-8515 HYPERLINK "http://www.frp.ca/CCFE" www.frp.ca/CCFE PAGE \* MERGEFORMAT 6
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