Surname First Initials. City Province/State Postal Code/Zip. Home telephone # Cell # Business telephone #

Save this PDF as:
Size: px
Start display at page:

Download "Surname First Initials. City Province/State Postal Code/Zip. Home telephone # Cell # Business telephone #"

Transcription

1 # West Broadway APPLICATION FOR CREDENTIAL AND PRIOR LEARNING ASSESSMENT (CPLA) PERSONAL INFORMATION (PLEASE PRINT): Surname First Initials Previous Surname Date of Birth DD/MM/YY MAILING ADDRESS: Street Address City Province/State Postal Code/Zip Home telephone # Cell # Business telephone # Address EDUCATION AND REGISTRATION INFORMATION: Name and address of school where massage therapy program completed Year program completed Number of hours in program Have you ever been registered as a massage therapist in another province, state, or country? Yes No If yes, in what province/state/country? Are you registered with any other health profession in British Columbia? Yes No If yes, with which college(s)? Send this form to the College of Massage Therapists of British Columbia, with the credential evaluation fee of $ This application will be valid for two years only.

2 CITIZENSHIP/RESIDENCE STATUS: Do you have Canadian citizenship, permanent resident status, or a valid work permit? Yes No One of the above is required at the time you register. If you will not meet this requirement by the time you are ready to register, please contact the College for information. FLUENCY: Can you speak and write either French or English with reasonable fluency? Yes No Acceptable evidence of fluency in written and spoken English or French is required to become eligible for registration. If you were not educated in Canada, please contact the College for information on meeting this requirement. Please indicate your preferred language of communication with the College (circle one). English / French DECLARATION OF REGISTRATION REQUIREMENTS: Please answer the questions below. You are required to answer the following questions at the time you register. We are requesting this information now to provide early notification to the College. If there is an issue so it can be addressed during the application process and to avoid delaying your registration when you have met the other registration requirements. 1. Have you ever been convicted of a criminal offence? Yes No 2. Has there ever been a finding of professional misconduct, incompetence, or incapacity or any like finding in British Columbia or any other jurisdiction in relation to massage therapy or another health profession? Yes No 3. Is there a current proceeding against you involving an allegation of professional misconduct, incompetence, or incapacity or any like finding in British Columbia or in any other jurisdiction in relation to your practice of massage therapy or another health profession? Yes No 4. Have you made an unsuccessful application for registration as a Health Professional in British Columbia or another jurisdiction? Yes No 5. Have you made an attempt to pass a licensing examination in British Columbia or another jurisdiction that has not yet resulted in a passing grade? Yes No If you answered yes to one or more of these questions, please attach a letter giving the details. I acknowledge that the personal information provided on this form is used by the College to determine if I meet the requirements for registration in British Columbia and for research and other projects related to the eligibility for registration of massage therapists trained outside British Columbia and is collected, used, and disclosed in accordance with the College Privacy Policy. I hereby certify that all statements I have made in all parts of this application form are true and complete. Please note that signing a document that you know provides false or misleading information may lead to a refusal of your application for registration.. Dated this day of, at Day Month Year City

3 # West Broadway Dear Administrator: Re: Application for credentialing An applicant for registration with the College of Massage Therapists of British Columbia is requesting that you provide the College with information about the massage therapy program he/she completed at your institution. Applicants for registration are required to have completed a massage therapy program that provides competencies equivalent to those provided by the programs currently being offered in British Columbia. Please complete the attached form and send it directly to the College with the following documents: 1. Official transcripts, supervised clinical practice hours, final grades, credits 2. Course descriptions/course syllabuses AND the grading scale relevant to the applicant s time of study. The transcript and course descriptions will enable us to determine if this applicant is eligible for registration in British Columbia as a massage therapist. Thank you for your assistance in this matter. If you have any questions, please contact the College of Massage Therapists of BC at Yours sincerely, Administration College of Massage Therapists of British Columbia

4 # West Broadway TRANSCRIPT REQUEST FORM To be completed by the applicant. Authorization to Release Information: Please complete this section and send this form to the school(s) at which you completed your massage therapy education. I, hereby authorize Name Name of school Address of school to provide the requested information concerning my massage therapy education to the College of Massage Therapists of British Columbia. Date To be completed by the massage therapy institution: Name of applicant (last name, first name, middle initial) Name of massage therapy institution Address of massage therapy institution Telephone number: ( _ ) Fax number: ( ) address: Is your school accredited? Yes / No If yes, who approves your school? Minimum academic entrance requirement: Start and finish dates of the applicant s program (month, year) Length of the program in hours

5 Please complete both pages of this document and return it directly to the College of Massage Therapists of British Columbia, at # W. Broadway Vancouver BC V6H 3V1 with the following documents: An official transcript with final grades, a record of supervised clinical practice hours completed and course descriptions/syllabuses used at the time the applicant completed the program. Program Content Information Subjects Theory hours Practical hours Health Sciences: Anatomy Physiology Musculoskeletal Anatomy Pathology Pain and Stress Pharmacology Public Health and Prevention Research Self Care Surgery Kinesiology Nutrition Neuroanatomy Neurophysiology Massage Therapy: Clinical Assessment Massage Theory and Techniques Massage Treatments Remedial Exercise Hydrotherapy Actinotherapy Professional Environment: Business, Ethics, and Professional Regulation Communications First Aid and CPR Total Hours Theory Practical This form was completed by: Name Position Date Please place your school seal and/or stamp here. Please attach the applicant s transcript(s), grades, clinical practice hours, course descriptions and grading scale to this document and return it to the College of Massage Therapists of British Columbia.

Application Form for Registration as a Social Worker

Application Form for Registration as a Social Worker Application Form for Registration as a Social Worker 250 Bloor St. E. Suite 1000 Toronto ON M4W 1E6 General Certificate of Registration for Social Work Social Work Degree Telephone: 416-972-9882 Toll Free:

More information

New Graduates of Canadian or U.S. Accredited Programs

New Graduates of Canadian or U.S. Accredited Programs New Graduates of Canadian or U.S. Accredited Programs In order to apply for registration with the Saskatchewan Association of and Audiologists (SASLPA), a new graduate is required to submit the following:

More information

Internationally Educated Medical Radiation Technologists APPLICATION for ASSESSMENT

Internationally Educated Medical Radiation Technologists APPLICATION for ASSESSMENT Internationally Educated Medical Radiation Technologists APPLICATION for ASSESSMENT Discipline for which you are applying: Radiological Technology Magnetic Resonance Nuclear Medicine Technology Radiation

More information

APPLICATION FOR PRE-REGISTRATION CANADA NEW PHARMACY TECHNICIAN GRADUATE. Please submit this application to the College of Pharmacists of BC

APPLICATION FOR PRE-REGISTRATION CANADA NEW PHARMACY TECHNICIAN GRADUATE. Please submit this application to the College of Pharmacists of BC Page 1 of 5 Please submit this application to the College of Pharmacists of BC CHECKLIST You must submit 1. Checklist (page 1). 2. Application form (page 2). 3. Copy of birth certificate or Canadian citizenship

More information

INITIAL CERTIFICATE APPLICATION GUIDE

INITIAL CERTIFICATE APPLICATION GUIDE INITIAL CERTIFICATE APPLICATION GUIDE CANADIAN GRADUATES 5060-3080 Yonge Street, Box 71 Toronto, Ontario M4N 3N1 416-975-5347 1-800-993-9459 www.caslpo.com Revised: May 2015 Reformatted: November 2014

More information

Application for Registered Social Worker Full Registration

Application for Registered Social Worker Full Registration Application for Registered Social Worker Full Registration Licensure Exam Requirement: In addition to completing the Application Package, new applicants will be required to complete a competency based

More information

College of Occupational Therapists of British Columbia Registration Reinstatement 2014-2015

College of Occupational Therapists of British Columbia Registration Reinstatement 2014-2015 College of Occupational Therapists of British Columbia Registration Reinstatement 2014-2015 In order to resume practice or use OT title in BC, your registration with the COTBC must be reinstated. Personal

More information

APPLICATION FOR REGISTRATION AS A GENERAL DENTIST

APPLICATION FOR REGISTRATION AS A GENERAL DENTIST North American and internationally trained dentists registering as a general dentist must complete the requirements of the Alberta Dental Association and College and the National Dental Examining Board

More information

College of Occupational Therapists of British Columbia Annual Registration Renewal 2015-2016

College of Occupational Therapists of British Columbia Annual Registration Renewal 2015-2016 College of Occupational Therapists of British Columbia Annual Registration Renewal 2015-2016 If you require assistance completing this form please refer to the Form Guide available on our web site at:

More information

Individual Application for Massage Therapy Iowa Department of Public Health/Bureau of Professional Licensure Board Office Telephone (515) 281-6959

Individual Application for Massage Therapy Iowa Department of Public Health/Bureau of Professional Licensure Board Office Telephone (515) 281-6959 For Office Use License #: Date Issued: $120 Individual Application for Massage Therapy Iowa Department of Public Health/Bureau of Professional Licensure Board Office Telephone (515) 281-6959 Applicant

More information

EARLY CHILDHOOD EDUCATOR APPLICATION / RENEWAL Assistant Certificate

EARLY CHILDHOOD EDUCATOR APPLICATION / RENEWAL Assistant Certificate EARLY CHILDHOOD EDUCATOR APPLICATION / RENEWAL Assistant Certificate For faster processing of your application, submit the following forms and documents. All forms can be found on the Early Childhood Educator

More information

AIT APPLICATION PACKAGE FOR REGISTRATION AS A PSYCHOLOGIST OR PSYCHOLOGICAL ASSOCIATE Version 2010-1

AIT APPLICATION PACKAGE FOR REGISTRATION AS A PSYCHOLOGIST OR PSYCHOLOGICAL ASSOCIATE Version 2010-1 THE PSYCHOLOGICAL ASSOCIATION OF MANITOBA 162-2025 Corydon Ave., Box # 253, Winnipeg, Manitoba R3P 0N5 Phone: (204) 487-0784 Fax: (204) 489-8688 Email: pam@mts.net Website: www.cpmb.ca AIT APPLICATION

More information

TEACHER QUALIFICATIONS SERVICE (TQS) APPLICATION FOR TEACHER CERTIFICATION AND SALARY EVALUATION

TEACHER QUALIFICATIONS SERVICE (TQS) APPLICATION FOR TEACHER CERTIFICATION AND SALARY EVALUATION TEACHER QUALIFICATIONS SERVICE (TQS) APPLICATION FOR TEACHER CERTIFICATION AND SALARY EVALUATION Your application will be considered complete when the following items have been received by the Registrar,

More information

OUT OF PROVINCE PRACTICAL NURSE

OUT OF PROVINCE PRACTICAL NURSE OUT OF PROVINCE PRACTICAL NURSE APPLICATION INSTRUCTIONS Effective January 1, 2016 This instruction guide provides general information to assist you in the application process. Further information will

More information

Requirements for application for Medical Licence in the Northwest Territories:

Requirements for application for Medical Licence in the Northwest Territories: Registrar, Professional Licensing Government of the Northwest Territories Department of Health and Social Services 8 th Floor, Centre Square Tower BOX 1320, 5022 49 ST YELLOWKNIFE NT X1A 2L9 Phone: (867)

More information

EARLY CHILDHOOD EDUCATOR APPLICATION / RENEWAL One Year Certificate

EARLY CHILDHOOD EDUCATOR APPLICATION / RENEWAL One Year Certificate EARLY CHILDHOOD EDUCATOR APPLICATION / RENEWAL One Year Certificate For faster processing of your application, submit the following forms and documents. All forms can be found on the Early Childhood Educator

More information

EARLY CHILDHOOD EDUCATOR FIRST TIME CERTIFICATE 5 Year, Infant & Toddler And/Or Special Needs

EARLY CHILDHOOD EDUCATOR FIRST TIME CERTIFICATE 5 Year, Infant & Toddler And/Or Special Needs Before submitting your application to the Early Childhood Educator Registry, refer to this checklist to ensure all required documents have been completed and submitted along with this application. Failure

More information

Application for Pharmacy Technician Register

Application for Pharmacy Technician Register Checklist Signed copy of this checklist Application form Sworn Statutory Declaration (page 3 of the application form) This document must be sworn with a commissioner for oaths, notary public or lawyer.

More information

APPLICATION FOR CERTIFICATE OF REGISTRATION AUTHORIZING SUPERVISED PRACTICE (Section 12, Regulation 74/15) Psychologist

APPLICATION FOR CERTIFICATE OF REGISTRATION AUTHORIZING SUPERVISED PRACTICE (Section 12, Regulation 74/15) Psychologist T H E C O L L E G E O F P S Y C H O L O G I S T S O F O N T I O L'O R D R E D E S P S Y C H O L O G U E S D E L ' O N T I O 110 Eglinton Avenue West, Suite 500, Toronto, Ontario M4R 1A3 Tel (416) 961-8817

More information

Nova Scotia College of Respiratory Therapists. Policy Handbook. Section 3 Membership and Licensure

Nova Scotia College of Respiratory Therapists. Policy Handbook. Section 3 Membership and Licensure NSCRT Policy Manual Section Three: Membership Page 1 Nova Scotia College of Respiratory Therapists Policy Handbook Section 3 Membership and Licensure Approved February 2013 NSCRT Policy Manual Section

More information

Application for Registration Clinical Register Pharmacist

Application for Registration Clinical Register Pharmacist Checklist Signed copy of this checklist Application form Sworn Statutory Declaration (page 3 of the application form) This document must be sworn with a commissioner for oaths, notary public or lawyer.

More information

Registration Guide. Please review this document carefully before completing the application

Registration Guide. Please review this document carefully before completing the application Registration Guide General Certificate of Registration for Social Work Combination of Academic Qualifications and Experience Performing the Role of a Social Worker Telephone: 416-972-9882 Toll Free: 1-877-828-9380

More information

APPLICATION FOR AUTONOMOUS PRACTICE PSYCHOLOGICAL ASSOCIATES APPLYING FOR REGISTRATION AS PSYCHOLOGISTS

APPLICATION FOR AUTONOMOUS PRACTICE PSYCHOLOGICAL ASSOCIATES APPLYING FOR REGISTRATION AS PSYCHOLOGISTS T H E C O L L E G E O F P S Y C H O L O G I S T S O F O N T A R I O L'O R D R E D E S P S Y C H O L O G U E S D E L ' O N T A R I O 110 Eglinton Avenue West, Suite 500, Toronto, Ontario M4R 1A3 Tel (416)

More information

Registration and Licensure as a Pharmacy Technician

Registration and Licensure as a Pharmacy Technician Registration and Licensure as a Pharmacy Technician For applicants who have studied in Canada or worked in the field of pharmacy and are not licensed to practise as a pharmacy technician in any jurisdiction.

More information

CHECKLIST Letter of Eligibility

CHECKLIST Letter of Eligibility Educator Services 128 1621 Albert Street Regina, SK Canada S4P 2S5 Tel: (306) 787-6085 Fax: (306) 787-1003 CHECKLIST Letter of Eligibility Application Packages are to be completed by the Independent School

More information

Application Instructions for:

Application Instructions for: Regular Mailing Address Courier Delivery Address P.O. Box 2649 2601 North Third Street Phone: 717-783-7155 email:ra-massagetherapy@state.pa.us Application Instructions for: MASSAGE THERAPIST TEMPORARY

More information

Registration Guide. Entry-to-Practice Examination Route

Registration Guide. Entry-to-Practice Examination Route Registration Guide Entry-to-Practice Examination Route June 2014 College of Kinesiologists of Ontario 160 Bloor Street East, Suite 1402 Toronto ON, M4W 1B9 registration@coko.ca 2 INTRODUCTION The College

More information

APPLICATION FOR CERTIFICATE OF REGISTRATION AUTHORIZING SUPERVISED PRACTICE (Section 5.(3), Regulation 533/98) Psychologist

APPLICATION FOR CERTIFICATE OF REGISTRATION AUTHORIZING SUPERVISED PRACTICE (Section 5.(3), Regulation 533/98) Psychologist T H E C O L L E G E O F P S Y C H O L O G I S T S O F O N T I O L'O R D R E D E S P S Y C H O L O G U E S D E L ' O N T I O 110 Eglinton Avenue West, Suite 500, Toronto, Ontario M4R 1A3 Tel (416) 961-8817

More information

Registration Guide. Alternative Registration Requirements - Grandparenting Route

Registration Guide. Alternative Registration Requirements - Grandparenting Route Registration Guide Alternative Registration Requirements - Grandparenting Route June 2014 College of Kinesiologists of Ontario 160 Bloor Street East, Suite 1402 Toronto, ON M4W 1B9 registration@coko.ca

More information

Schedule K: Dental Assistant Registration Form

Schedule K: Dental Assistant Registration Form 1. Applicant Type Check one: Domestic Accredited Domestic Non-Accredited USA Accredited International 2. Personal Information Male Female a) Name Last Name: Given Names (underline name commonly used):

More information

Registration and Licensure as a Pharmacy Technician

Registration and Licensure as a Pharmacy Technician Registration and Licensure as a Pharmacy Technician For applicants who are currently licensed to practise as a pharmacy technician in a Canadian jurisdiction outside New Brunswick. Please read all pages

More information

CHECKLIST - Probationary Certificate (Subsequent Application)

CHECKLIST - Probationary Certificate (Subsequent Application) Educator Services 128 1621 Albert Street Regina, SK Canada S4P 2S5 Tel: (306) 787-6085 Fax: (306) 787-1003 CHECKLIST - Probationary Certificate (Subsequent Application) Application Packages are to be completed

More information

APPLICATION INSTRUCTIONS FOR DENTAL ASSISTANT ASSESSMENT

APPLICATION INSTRUCTIONS FOR DENTAL ASSISTANT ASSESSMENT 500 1765 West 8th Avenue Vancouver BC Canada V6J 5C6 www.cdsbc.org Phone 604 736 3621 Toll Free 1 800 663 9169 Facsimile 604 734 9448 APPLICATION INSTRUCTIONS FOR DENTAL ASSISTANT ASSESSMENT The assessment

More information

APPLICATION FOR TEMPORARY LICENCE

APPLICATION FOR TEMPORARY LICENCE APPLICATION FOR TEMPORARY LICENCE Name of Applicant (Please Print) Date of Application Revised, January 2003 IDENTIFICATION NAME IN FULL: (Please Type or Print) (Surname) (First Name) (Initial) RESIDENCE

More information

Nurse Practitioner Registration in British Columbia. Application Package for B.C. Graduates C H E C K L I S T C O N T E N T S

Nurse Practitioner Registration in British Columbia. Application Package for B.C. Graduates C H E C K L I S T C O N T E N T S Canada V6J 3Y8 Tel: 604.736.7331 Fax: 604.736.3576 www.crnbc.ca Nurse Practitioner Registration in British Columbia Application Package for B.C. Graduates C O N T E N T S Form 6: Application for Nurse

More information

Application Package for Nurse Registration in British Columbia Internationally-Educated Nurses Not Registered in Canada

Application Package for Nurse Registration in British Columbia Internationally-Educated Nurses Not Registered in Canada 2855 Arbutus Street Vancouver, BC Canada V6J 3Y8 Tel: 604.736.7331 Toll-free: 1.800.565.6505 Fax: 604.736.3576 Application Package for Nurse Registration in British Columbia Internationally-Educated Nurses

More information

APPLICATION FOR EVALUATION OF FOREIGN SOCIAL WORK CREDENTIALS

APPLICATION FOR EVALUATION OF FOREIGN SOCIAL WORK CREDENTIALS APPLICATION FOR EVALUATION OF FOREIGN SOCIAL WORK CREDENTIALS For persons located in, or immigrating to, the province of Alberta, Saskatchewan, Manitoba, Ontario, New Brunswick, Newfoundland, Nova Scotia,

More information

Athletic Trainer License Application Methods

Athletic Trainer License Application Methods Athletic Trainer License Application Methods Please read carefully to determine the application method for which you are qualified Indicate the appropriate method on the application and submit the required

More information

New Brunswick Association of Counselling Therapists

New Brunswick Association of Counselling Therapists Membership Information NBACT - New Brunswick Association of Counselling Therapists, formerly known as the Stakeholder s Group, was incorporated in January 2009. Members of the Association are professional

More information

Bachelor of Computer Science (ICS) Program. 2011 Application Form

Bachelor of Computer Science (ICS) Program. 2011 Application Form Bachelor of Computer Science (ICS) Program 2011 Application Form Information for Applicants: Requirements: 1. A bachelor's degree: in a non-computer related area (e.g., arts, science, commerce, music,

More information

DSHS Publication #64-10701 MASSAGE THERAPY LICENSE APPLICATION

DSHS Publication #64-10701 MASSAGE THERAPY LICENSE APPLICATION DSHS Publication #64-10701 MASSAGE THERAPY LICENSE APPLICATION BUDGET ZZ121 FUND 105 PRINT or TYPE all information on the application. Please answer all questions completely, do not leave any blank. The

More information

Professional Credential Services, Inc.

Professional Credential Services, Inc. Professional Credential Services, Inc. P.O. Box 198689 - Nashville, TN 37219-8689 www.pcshq.com Licensure Application for Athletic Trainers For the Massachusetts Board of Allied Health Professionals If

More information

Application Information. for recent graduates of a BC teacher education program

Application Information. for recent graduates of a BC teacher education program Application Information for recent graduates of a BC teacher education program August 2015 Table of Contents About the BC Ministry of Education Teacher Regulation Branch... 2 Certificates Issued... 3 How

More information

Instructions Welcome to University Canada West

Instructions Welcome to University Canada West Instructions Welcome to University Canada West To fast track your graduate application, please follow the instructions carefully. For Graduate Students 1. Please note: It is necessary for you to read and

More information

STATE OF MAINE MASSAGE THERAPY PROGRAM APPLICATION FOR LICENSURE. Massage Therapist

STATE OF MAINE MASSAGE THERAPY PROGRAM APPLICATION FOR LICENSURE. Massage Therapist STATE OF MAINE MASSAGE THERAPY PROGRAM APPLICATION FOR LICENSURE Massage Therapist Department of Professional and Financial Regulation Office of Professional and Occupational Regulation 35 State House

More information

Application for Membership

Application for Membership CERTIFIED REGISTERED MASSAGE THERAPIST ASSOCIATION Office Use Only Member Type: Member #: Date: Approved: Change Date: Application for Membership If you are a graduate of a 2,200 hour program in Alberta,

More information

EARLY CHILDHOOD EDUCATOR RENEWAL CERTIFICATE 5 Year, Infant & Toddler And/Or Special Needs

EARLY CHILDHOOD EDUCATOR RENEWAL CERTIFICATE 5 Year, Infant & Toddler And/Or Special Needs EARLY CHILDHOOD EDUCATOR RENEWAL CERTIFICATE 5 Year, Infant & Toddler And/Or Special Needs For faster processing of your application, submit the following forms and documents All forms can be found on

More information

APPLICATION FOR A CHANGE TO THE MASSAGE THERAPY SCHOOL LICENSE

APPLICATION FOR A CHANGE TO THE MASSAGE THERAPY SCHOOL LICENSE This form may be printed, completed and mailed to the address listed below. Attachment B DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH Licensure Unit P.O. Box 94986, Lincoln, Nebraska

More information

National Nursing Assessment Service (NNAS)

National Nursing Assessment Service (NNAS) National Nursing Assessment Service (NNAS) Applicant Handbook NNAS Application Information NNAS Website: http://www.nnas.ca/ NNAS Customer Care: +1-855-977-1898 (If toll free is not available): +1-215-349-9370

More information

Apply now to join the family!

Apply now to join the family! Apply now to join the family! In order to assess your application for employment, needs to collect personal information about you which may be regulated by the Personal Information Protection and Electronic

More information

APPLYING TO THE COLLEGE VIDEO PRESENTATION VOICE SCRIPT SLIDE NUMBER

APPLYING TO THE COLLEGE VIDEO PRESENTATION VOICE SCRIPT SLIDE NUMBER 1 2 3 SLIDE NUMBER TEXT ON SLIDE The Ontario College of Teachers (logo) Information Session Applying to the College Information Overview Basic Requirements Application Tips Two Step Registration Process

More information

Combined Master s Program Application

Combined Master s Program Application Chartered Professional Accountants of Ontario 25 York Street Suite 1100 Toronto ON M5J 2V5 T. 416 977.7741 F. 416 977.6079 Toll Free 1 800 387.2991 www.cpaontario.ca Candidate No: (Office use only) Combined

More information

Study of Registration Practices of the

Study of Registration Practices of the COLLEGE OF MASSAGE THERAPISTS OF ONTARIO, 2007 This study was prepared by the Office of the Fairness Commissioner (OFC). We encourage its citation and distribution for non-commercial purposes, provided

More information

MANITOBA DENTAL ASSOCIATION 202-1735 Corydon Avenue, Winnipeg, MB, R3N 0K4 www.manitobadentist.ca

MANITOBA DENTAL ASSOCIATION 202-1735 Corydon Avenue, Winnipeg, MB, R3N 0K4 www.manitobadentist.ca MANITOBA DENTAL ASSOCIATION INSTRUCTIONAL GUIDE FOR COMPLETING DENTAL ASSISTANT REGISTRATION APPLICATION FORM MANITOBA DENTAL ASSOCIATION 202-1735 Corydon Avenue, Winnipeg, MB, R3N 0K4 www.manitobadentist.ca

More information

Guide Sheet for Application for Dental Assistant Registration

Guide Sheet for Application for Dental Assistant Registration Guide Sheet for Application for Dental Assistant Registration General Complete all fields of the application in full. Enter N/A for information that does not apply to you. Submit the completed original

More information

COLLEGE OF DENTAL TECHNICIANS OF BRITISH COLUMBIA

COLLEGE OF DENTAL TECHNICIANS OF BRITISH COLUMBIA COLLEGE OF DENTAL TECHNICIANS OF BRITISH COLUMBIA GENERAL INFORMATION REGARDING REGISTRATION AS A DENTAL TECHNICIAN AND REQUIRED LICENSURE EXAMINATIONS June 2014 Subject to revision [The College of Dental

More information

ASSOCIATION OF REGISTERED NURSES OF PRINCE EDWARD ISLAND

ASSOCIATION OF REGISTERED NURSES OF PRINCE EDWARD ISLAND ASSOCIATION OF REGISTERED NURSES OF PRINCE EDWARD ISLAND Tel: 902-368-3764 Fax: 902-628-1430 Email: info@arnpei.ca Instructions for Applying for Endorsement as a Nurse Practitioner in Prince Edward Island

More information

HAWAII BOARD OF MASSAGE THERAPY Frequently Asked Questions 2/27/2012

HAWAII BOARD OF MASSAGE THERAPY Frequently Asked Questions 2/27/2012 HAWAII BOARD OF MASSAGE THERAPY Frequently Asked Questions 2/27/2012 The answers to general questions (e.g. change of address, name change, duplicate pocket i.d. card/wall certificate, license verification

More information

REQUEST FOR ASSESSMENT OF A VETERINARY TECHNOLOGY / ANIMAL HEALTH TECHNOLOGY PROGRAM

REQUEST FOR ASSESSMENT OF A VETERINARY TECHNOLOGY / ANIMAL HEALTH TECHNOLOGY PROGRAM REQUEST FOR ASSESSMENT OF A VETERINARY TECHNOLOGY / ANIMAL HEALTH TECHNOLOGY PROGRAM Application Procedures 1. Please complete the ICAS Application Form (including the Document Submission Form, Payment

More information

Number street apartment. municipality province postal code

Number street apartment. municipality province postal code Form updated on 20160307 APPLICATION FOR ISSUANCE of a licence REAL ESTATE OR MORTGAGE BROKER IMPORTANT A licence application is deemed received once all information and documents required hereunder have

More information

APPLICATION FOR REGISTRATION:

APPLICATION FOR REGISTRATION: APPLICATION FOR REGISTRATION: POSTGRADUATE EDUCATION - 2015 CANADIAN MEDICAL SCHOOL GRADUATES MATCHED TO AN ONTARIO RESIDENCY PROGRAM Dear Applicant: The College is pleased to provide this application

More information

D Arcy Lane Institute of Massage Therapy. D AL School of Equine Massage Therapy. Providing Quality Education in Massage Therapy since 1986

D Arcy Lane Institute of Massage Therapy. D AL School of Equine Massage Therapy. Providing Quality Education in Massage Therapy since 1986 September 2013 Equine Massage Therapy Program Guide Providing Quality Education in Massage Therapy since 1986 D Arcy Lane Institute of Massage Therapy D AL School of Equine Massage Therapy 627 Maitland

More information

Mental Health Counselor Credentialing. Activation Application Packet. Contents: Important Social Security Number Information:

Mental Health Counselor Credentialing. Activation Application Packet. Contents: Important Social Security Number Information: Mental Health Counselor Expired Credential Activation Application Packet Contents: 1. 670-078...Contents List/SSN Information/Mailing Information... 1 page 2. 670-077...Application Instructions Checklist...2

More information

INSTRUCTION TO APPLICANTS FOR LICENSURE AS A OCCUPATIONAL THERAPIST OR OCCUPATIONAL THERAPY ASSISTANT

INSTRUCTION TO APPLICANTS FOR LICENSURE AS A OCCUPATIONAL THERAPIST OR OCCUPATIONAL THERAPY ASSISTANT INSTRUCTION TO APPLICANTS FOR LICENSURE AS A OCCUPATIONAL THERAPIST OR OCCUPATIONAL THERAPY ASSISTANT A. TEMPORARY LICENSE (90 DAYS)- Applicant must submit the following: Temporary licenses are valid for

More information

MUTUAL RECOGNITION AGREEMENT Agreement on the Mobility of Massage Therapists between British Columbia, Newfoundland and Labrador and Ontario

MUTUAL RECOGNITION AGREEMENT Agreement on the Mobility of Massage Therapists between British Columbia, Newfoundland and Labrador and Ontario MUTUAL RECOGNITION AGREEMENT Agreement on the Mobility of Massage Therapists between British Columbia, Newfoundland and Labrador and Ontario This Agreement is between: THE COLLEGEOF MASSAGE THERAPISTS

More information

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care.

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care. Aged Care Education and Training Incentive Programme COMPLETION PAYMENT This application form is to be completed by applicants who have completed studies and have already received a commencement payment

More information

TEMPORARY EMR REGISTRATION INSTRUCTIONS

TEMPORARY EMR REGISTRATION INSTRUCTIONS REGISTRATION INSTRUCTIONS Please ensure you read all of the instructions completely before submitting your application for registration. All sections of the Temporary EMR Registration Form must be completed.

More information

Application Package. Provisional Practice. September 2014. 2014 College of Physiotherapists of Ontario

Application Package. Provisional Practice. September 2014. 2014 College of Physiotherapists of Ontario Application Package Provisional Practice September 2014 2014 College of Physiotherapists of Ontario Provisional Practice Application Package Provisional Practice is a registration category that covers

More information

Admission Checklist Complete this form and enclose it with your application form. Thanks

Admission Checklist Complete this form and enclose it with your application form. Thanks 1 Master of Counselling (MC) Admission Checklist Complete this form and enclose it with your application form. Thanks Applicant s Name: Last First Middle City University of Seattle Application form (completed,

More information

Board Massage Therapy

Board Massage Therapy Michigan Department of Licensing and Regulatory Affairs Bureau of Health Care Services Board of Massage Therapy PO Box 30670 Lansing MI 48909 (517) 335-0918 www.michigan.gov/healthlicense Page 1 of 15

More information

NURSING. East Mississippi Community College P.O. Box 100 Mayhew, MS 39753 (662) 243-1910 2012-2013 PRACTICAL NURSING ADMISSION REQUIREMENTS

NURSING. East Mississippi Community College P.O. Box 100 Mayhew, MS 39753 (662) 243-1910 2012-2013 PRACTICAL NURSING ADMISSION REQUIREMENTS NURSING East Mississippi Community College P.O. Box 100 Mayhew, MS 39753 (662) 243-1910 2012-2013 PRACTICAL NURSING ADMISSION REQUIREMENTS Disclaimer The content and requirements of this admission packet

More information

MASSAGE THERAPY APPLICATION FOR A LICENSE TO PRACTICE

MASSAGE THERAPY APPLICATION FOR A LICENSE TO PRACTICE Department of Health and Human Services Division of Public Health - Licensure Unit P.O. Box 94986 - Lincoln, Nebraska 68509-4986 Telephone #: 402-471-4918 rita.watson@nebraska.gov MASSAGE THERAPY APPLICATION

More information

LP License Expires 90 days from date of NBCOT Eligibility to Test Letter PERSONAL INFORMATION EDUCATION LICENSURE & HISTORY INFORMATION

LP License Expires 90 days from date of NBCOT Eligibility to Test Letter PERSONAL INFORMATION EDUCATION LICENSURE & HISTORY INFORMATION Oregon Occupational Therapy Licensing Board State Office Building, 800 NE Oregon St., Suite 407 Portland, OR 97232 www.otlb.state.or.us Phone: 971-673-0198 FAX: 971-673-0226 Felicia Holgate, Director Felicia.M.Holgate@state.or.us

More information

Physical Therapist Assistant Program

Physical Therapist Assistant Program Physical Therapist Assistant Program Application and Procedure Packet Admissions Office Olympic College 1600 Chester Ave. Bremerton, WA 98337 360-475-7479 Update on November 13, 2015 Physical Therapist

More information

2015-2016 Dependent Aggregate Verification

2015-2016 Dependent Aggregate Verification V5- DEP FORM 2015-2016 Dependent Aggregate Verification Your 2015-2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called Aggregate Verification. Northern is required

More information

This service benefits clients needing an RCMP certified background check that are currently living overseas.

This service benefits clients needing an RCMP certified background check that are currently living overseas. Commissionaires BC is able to create applications for Criminal Record Checks which we can submit to the RCMP for processing. Criminal Record Checks are processed through the National Canadian Police Information

More information

EXCLUSIVE ERRORS & OMISSIONS INSURANCE APPLICATION FOR MEMBERS OF THE MORTGAGE BROKERS ASSOCIATION OF BRITISH COLUMBIA

EXCLUSIVE ERRORS & OMISSIONS INSURANCE APPLICATION FOR MEMBERS OF THE MORTGAGE BROKERS ASSOCIATION OF BRITISH COLUMBIA EXCLUSIVE ERRORS & OMISSIONS INSURANCE APPLICATION FOR MEMBERS OF THE MORTGAGE BROKERS ASSOCIATION OF BRITISH COLUMBIA THIS APPLICATION SHALL FORM PART OF ANY ERRORS & OMISSIONS / PROFESSIONAL LIABILITY

More information

Teacher Qualifications Service (TQS)

Teacher Qualifications Service (TQS) Teacher Qualifications Service (TQS) Application Form and Guide Book What is TQS? The Teacher Qualifications Service (TQS) is the agency in Alberta responsible for evaluating teachers years of education

More information

APPLICATION FOR TEACHING POSITION. Address: Suite or House No. Street No. and Name or P.O. Box

APPLICATION FOR TEACHING POSITION. Address: Suite or House No. Street No. and Name or P.O. Box Date of application: APPLICATION FOR TEACHING POSITION Surname Given name and initial Address: Suite or House No. Street No. and Name or P.O. Box City Province Country Postal Code Telephone No. Home: Cell:

More information

President s Message. Sincerely, Dr. Verna Magee-Shepherd President and Vice Chancellor

President s Message. Sincerely, Dr. Verna Magee-Shepherd President and Vice Chancellor President s Message University Canada West is an expanding, young university. At its campus located in Vancouver, one of the top ranked cities in the world according to UNESCO based on the standard of

More information

Marriage and Family Therapist Associate

Marriage and Family Therapist Associate Marriage and Family Therapist Associate License Application Packet Contents: 1. 670-096... Contents List/SSN Information/Mailing Information...1 page 2. 670-097... Application Instructions Checklist...3

More information

APPLICATION FOR ASSESSMENT: Special Education Teacher (not elsewhere classified) (ANZSCO 241599)

APPLICATION FOR ASSESSMENT: Special Education Teacher (not elsewhere classified) (ANZSCO 241599) Effective: 01 January 2014 APPLICATION FOR ASSESSMENT: Special Education Teacher (not elsewhere classified) (ANZSCO 241599) The Australian Institute for Teaching and School Leadership (AITSL) Ltd has been

More information

Application for Witness

Application for Witness Compensation for Victims of Crime Program Application for Witness The Compensation for Victims of Crime Program is part of Manitoba Justice, Victim Services Branch and gives compensation to eligible witnesses

More information

FCCPT Credentials Evaluation Application Packet

FCCPT Credentials Evaluation Application Packet Application Packet Do not use this form if you are applying for a license in New York State. Use the NYS Credentials Verification Application. Dear Applicant: This application packet is intended for individuals

More information

Medical Assistant-Phlebotomist Certification Application Packet

Medical Assistant-Phlebotomist Certification Application Packet Medical Assistant-Phlebotomist Certification Application Packet Contents: 1. 651-007...Contents List/SSN Information/Mailing Information...1 page 2. 651-008...Application Instructions Checklist... 2 pages

More information

ELECTRICIAN APPLIED CERTIFICATE

ELECTRICIAN APPLIED CERTIFICATE ELECTRICIAN APPLIED CERTIFICATE LENGTH OF COURSE 21 weeks LOCATION OF COURSE Estevan & Moosomin ADMISSION REQUIREMENTS Grade 11 with Foundations of Mathematics 20 or Workplace and Apprenticeship Mathematics

More information

WCCMT s 20 Month Competency-Based Mastery Level RMT Program

WCCMT s 20 Month Competency-Based Mastery Level RMT Program WCCMT s 20 Month Competency-Based Mastery Level RMT Program 1 Table of Content About our Program 3 Payment Schedule. 5 Curriculum. 6 Semester Review. 7 Board Examination Prep Program. 8 Clinical Practicum..

More information

APPLICATION FOR GRADUATE ADMISSION

APPLICATION FOR GRADUATE ADMISSION APPLICATION FOR GRADUATE ADMISSION Office of Graduate Programs Pace Law School 78 rth Broadway White Plains, New York 10603 U.S.A. Telephone: (+1) 914 422 4670 E Mail: llm@law.pace.edu 1. How did you first

More information

PERSONAL DETAILS BASIS FOR APPLICATION

PERSONAL DETAILS BASIS FOR APPLICATION APPLICATION FM (for transitional arrangements only) APS SUPERVISED PRACTICE ASSOCIATE MEMBER - MASTERS ROUTE APS COLLEGES PERSONAL DETAILS Dr c Mr c Mrs c Ms c Miss c Other c Family name: Former name (if

More information

INSTRUCTIONS FOR APPLICANTS WHO HOLD NBRC CERTIFICATION

INSTRUCTIONS FOR APPLICANTS WHO HOLD NBRC CERTIFICATION Email: st-medicine@pa.gov st-osteopahtic@pa.gov Medicine 717-783-1400/717-787-2381 Osteopathic 717-783-4858 APPLICATION FOR LICENSURE AS A RESPIRATORY THERAPIST This application can be used for licensure

More information

BOARD OF DENTAL EXAMINERS Application for Registration as a Dental Assistant (Traditional/Certified)

BOARD OF DENTAL EXAMINERS Application for Registration as a Dental Assistant (Traditional/Certified) Vermont Secretary of State Office of Professional Regulation 89 Main Street, 3 rd Floor Montpelier VT 05620-3402 Diane Lafaille Licensing Board Specialist (802) 828 2390 diane.lafaille@sec.state.vt.us

More information

REQUEST TO AMEND THE RECORD OF LANDING (IMM 1000), CONFIRMATION OF PERMANENT RESIDENCE (IMM 5292 or IMM 5688) OR VALID TEMPORARY RESIDENT DOCUMENTS

REQUEST TO AMEND THE RECORD OF LANDING (IMM 1000), CONFIRMATION OF PERMANENT RESIDENCE (IMM 5292 or IMM 5688) OR VALID TEMPORARY RESIDENT DOCUMENTS PROTECTED WHEN COMPLETED - B REQUEST TO AMEND THE RECORD OF LANDING (IMM 1000), CONFIRMATION OF PERMANENT RESIDENCE (IMM 5292 or IMM 5688) OR VALID TEMPORARY RESIDENT DOCUMENTS PAGE 1 OF 3 PART A - PERSONAL

More information

Ontario College of Social Workers and Social Service Workers. The Centre for Education & Training 2011

Ontario College of Social Workers and Social Service Workers. The Centre for Education & Training 2011 Ontario College of Social Workers and Social Service Workers The Centre for Education & Training 2011 Regulation of Two Professions Social Work and Social Service Work College s key regulatory responsibility

More information

BOARD OF REGISTRATION OF MASSAGE THERAPY Instructions for Initial Massage Therapist License Application

BOARD OF REGISTRATION OF MASSAGE THERAPY Instructions for Initial Massage Therapist License Application BOARD OF REGISTRATION OF MASSAGE THERAPY Instructions for Initial Massage Therapist License Application 1. Please read and review the Board s regulations governing Individual Licensure at CMR 3.00 and/or

More information

30 Day Limited Permits for Professional Engineers and Land Surveyors

30 Day Limited Permits for Professional Engineers and Land Surveyors THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12234 Office of the Professions, State Board for Engineering and Land Surveying PHONE: 518-474-3817 ext. 140 FAX: 518-473-6282

More information

This guide outlines and assists Toronto Pearson employees with the application process in obtaining Transportation Security Clearance and their

This guide outlines and assists Toronto Pearson employees with the application process in obtaining Transportation Security Clearance and their This guide outlines and assists Toronto Pearson employees with the application process in obtaining Transportation Security Clearance and their Restricted Area Identity Card (RAIC). 2014 List 1 Proof of

More information

The College is pleased to provide this application for a Postgraduate Education certificate of registration for an elective appointment.

The College is pleased to provide this application for a Postgraduate Education certificate of registration for an elective appointment. Dear Applicant: The College is pleased to provide this application for a Postgraduate Education certificate of registration for an elective appointment. Note that this application package is for graduates

More information

Instructions for Form 5 Application to Withdraw or Transfer Money from an Ontario Locked-in Account

Instructions for Form 5 Application to Withdraw or Transfer Money from an Ontario Locked-in Account Financial Services Commission of Ontario Instructions for Form 5 Application to Withdraw or Transfer Money from an Ontario Locked-in Account General Information You must complete the attached application

More information

Dear Applicant: Criteria for admission to the program includes:

Dear Applicant: Criteria for admission to the program includes: Dear Applicant: Thank you for your interest in the Social Work Program at Defiance College. The Program has a long history of training baccalaureate students to become effective, beginning level, social

More information

Columbia University Programs in Occupational Therapy Office of Admission ----------------------------------- FREQUENTLY ASKED QUESTIONS

Columbia University Programs in Occupational Therapy Office of Admission ----------------------------------- FREQUENTLY ASKED QUESTIONS Columbia University Programs in Occupational Therapy Office of Admission ----------------------------------- FREQUENTLY ASKED QUESTIONS Dear Applicant, As you prepare your application for admission to

More information