Accredited Degree Assessment

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1 Accredited Degree Assessment 1 - Applicant Information Salutation: q Mr. q Ms. q Dr. Business Address: Organization Name: Street Address: City: Province: Postal Code: Bus. Phone: Bus. Fax: Home Address: Street Address: City: Province: Postal Code: Home Phone: Home Fax: Preferred contact: q Business q Home Cell Phone: 2 - Current Professional Work Information Position Title / Role: NOTE: Please arrange to have your employer send a letter confirming your current employment and job description directly to the Professional Standards Board. Accredited Degree Assessment Page 1 of 5

2 3 - Post-Secondary Education Information If you hold a completed post-secondary degree in planning from a CIP-accredited university planning degree program, please identify it from the list in Appendix A, and enter the details below. Please note that CIP/PSB also recognize degrees accredited by the Planning Accreditation Board and the Planning Institute of Australia. Please check their websites (http://www.planningaccreditationboard.org/index.php?id=30 and planning.org.au/becomeaplanner/accredited-university-courses) for a current listing. Also kindly note that the list of CIP-recognized degrees was correct at time of printing, but you should check the PSB website (http://www.psb-planningcanada.ca/certification/accreditedplanningprograms.php) to see if your degree program is currently accredited. Degree(s): Institution: Year Conferred: NOTE: You will be required to have Official Transcripts from the Institution(s) where you received any university degree(s) sent directly to the Professional Standards Board in conjunction with this application. To permit us to begin the evaluation process, you may attach a photocopy of your degree(s). However, your status as a candidate cannot be confirmed until we receive your transcripts. Please provide information on all other post-secondary degree credentials you currently hold that you would like us to consider: Degree(s): Institution: Year Conferred: NOTE: You will be required to have Official Transcripts from the Institution(s) where you received any university degree(s) sent directly to the Professional Standards Board in conjunction with this application. To permit us to begin the evaluation process, you may attach a photocopy of your degree(s). However, your status as a candidate cannot be confirmed until we receive your transcripts. If you received your degree(s) from a university outside Canada, you will be required to have your degree credentials assessed by a designated foreign credential evaluation service, and have that assessment report sent directly to the Professional Standards board. Please provide information on all other post-secondary credentials you currently hold: Other Credentials(s) (Diplomas, etc.): Institution: Year Conferred: 4. NOTE: PSB recognizes foreign credential evaluations from two sources: Canadian Information Centre for International Credentials, Toronto, ON / International Qualifications Assessment Service (IQAS), Edmonton, AB / However, your application for assessment cannot be confirmed until we receive your transcripts. Accredited Degree Assessment Page 2 of 5

3 4 - Planning Work Experience Summary Information Please provide summary information on your current and recent or previous planning work: Position Title / Role: Employer / Organization: Years From To: Mentor Information Please indicate the name of the CIP Full Member you have identified and who has agreed to serve as your Mentor: NOTE: Please consult the Prospective Membership Guide for details on the role of the Mentor. 6 - Sponsor Information Please indicate the name of the CIP Certified Member you have identified and who has agreed to serve as your Sponsor: NOTE: Please consult the Prospective Membership Guide for details on the role of the Sponsor. 7 - Checklist of Enclosures / Supporting Documentation Please ensure that you have completed this form fully, including all required supporting documentation: q Payment of Applicable Assessment Fee(s) - See fee and payment schedule below q Employment Letter & Job Description - To be sent directly by Employer to PSB q Official University Degree Transcripts - To be sent directly by Insititution to PSB q Foreign Credential Evaluation Report - To be sent directly by Evaluation Service to PSB (if applicable) q Confirmation of Affiliate Membership Please provide your membership number to PSB once it has been issued Accredited Degree Assessment Page 3 of 5

4 Applicant Certification & Signature: I certify that the information provided on this form (and in any enclosed or supporting documentation) is accurate and correct. Applicant Signature: 8 - Assessment Fee Payment: Payment of the applicable assessment fee of $ (plus HST/GST*) must accompany this application. Payment may be made by cheque, money order payable to the Professional Standards Board or by credit card: q Visa q MasterCard Card Number: CVV: Expiry: / Name on Card: Signature: NOTE: Fee does not include Affiliate/CIP membership, which must be obtained directly from your local Affiliate. * FEE PAYMENT TAX CHART: $ $18.75 GST = $ (if your province or territory of residence is PE / MB / SK / AB / NU / NT / YK), or $ $48.75 HST = $ (if your province of residence is NB / NL / ON), or $ $56.25 HST = $ (if your province of residence is NS), or $ $18.75 GST = $ (if your province of residence is BC) Please send completed form to: Professional Standards Board th Avenue, Suite 210 Markham, ON L3R 0E4 Tel: (647) Toll-free: Fax: (416) Accredited Degree Assessment Page 4 of 5

5 APPENDIX A - Accredited Degrees To complete Section 3 of this form, please locate information for any post-secondary degree in planning from a CIP-accredited university planning degree program that you received and enter the Institution Name, Program Name and Year Granted in the list in Section 3. Please note that CIP/PSB also recognize degrees accredited by the Planning Accreditation Board and the Planning Institute of Australia. Please check their website (http://www.planningaccreditationboard.org/index.php?id=30 and planning.org.au/becomeaplanner/accredited-university-courses) for a current listing. Also kindly note that the list of CIP-recognized degrees was correct at time of printing, but you should check the PSB website (http://www.psb-planningcanada.ca/certification/ accreditedplanningprograms.php) to see if your degree program is currently accredited. University of British Columbia M.A. (Community and Regional Planning) ( ) M.Sc. (Community and Regional Planning) ( ) University of Calgary Master of Planning ( ) Dalhousie University Master of Planning ( ) Bachelor of Community Design Honours Major in Environmental Planning ( ) Bachelor of Community Design Honours Major in Urban Design Studies ( ) Bachelor of Community Design Honours Major in Urban Design Studies with a Minor in Environmental Studies ( ) Bachelor of Community Design Honours Major in Environmental Planning with a Minor in Environmental Studies ( ) Bachelor of Community Design Honours Double Major Community Design (Urban Design Studies) and Sustainability ( ) Bachelor of Community Design Honours Double Major Community Design (Environmental Planning) and Sustainability ( ) University of Guelph M.Sc. (Rural Planning & Development, Canadian Stream) ( ) M.Sc. (Rural Planning & Development, International Stream) ( ) Université Laval Maîtrise en aménagement du territoire et développement régional ( ) University of Manitoba Master of City Planning ( ) McGill University Master of Urban Planning ( ) Université de Montréal Maîtrise en urbanisme ( ) Baccalauréat ès-sciences spécialisé en urbanisme ( ) University of Northern British Columbia Bachelor of Planning (BPL) ( ) Université du Québec à Montréal Baccalauréat ès sciences spécialisé en urbanisme ( ) Queen s University Master of Urban & Regional Planning ( ) Ryerson University Master of Planning in Urban Development ( ) Bachelor of Urban and Regional Planning (PLAN) ( ) Post Degree Bachelor of Urban and Regional Planning (PLAB) ( ) Post Diploma Bachelor of Urban and Regional Planning (PLAD) ( ) University of Saskatchewan B.A. in Regional and Urban Planning ( ) Simon Fraser University Master of Resource Management (Planning) ( ) University of Toronto M.Sc. (Planning) ( ) University of Waterloo Bachelor of Environmental Studies Honours Co-op Planning ( ) Master of Arts (Planning) ( ) Master of Environmental Studies (Planning)( ) Doctor of Philosophy (Planning) ( ) York University Master in Environmental Studies (Planning) ( ) PAST PROGRAMS RECOGNIZED BY CIP University of British Columbia Ph.D. (Community and Regional Planning) ( ) University of Calgary Master of Environmental Design (Planning) ( ) PhD Environmental Design ( ) Dalhousie University Master of Engineering/Master of Planning ( ) Master of Applied Science/Master of Planning ( ) Master of Urban and Rural Planning ( ) Master of Engineering/Master of Urban and Rural Planning ( ) Master of Applied Science/Master of Urban and Rural Planning ( ) Bachelor of Community Design; Honours, (Environmental Planning) ( ) Bachelor of Community Design; Honours, (Urban Design Studies) ( ) University of Northern British Columbia Bachelor of Science, Environmental Planning ( ) Nova Scotia College Of Art And Design Bachelor of Design in Environmental Planning ( ) University of Ottawa Master of Planning ( ) University of Saskatchewan B.A. in Regional and Urban Development ( ) University of Toronto Diploma in Town and Regional Planning ( ) Ph.D. Urban and Regional Planning ( ) University of Windsor Honours Bachelor of Arts (Planning) ( ) Accredited Degree Assessment Page 5 of 5

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