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NameAddressTelephoneEmail Instructions Review About CCFE document ( HYPERLINK "http://www.frp.ca/CCFE" www.frp.ca/CCFE) prior to completing application Save application form to fill in electronically Return five complete copies of application package by deadline date with payment to: Canadian Association of Family Resource Programs (FRP Canada) 707 331 Cooper Street Ottawa, Ontario K2P 0G5 Payment form found at  HYPERLINK "http://www.frp.ca/CCFE" www.frp.ca/CCFE Use staples or clips for application copies NO binders or duotangs please Enclose completed checklist (last page of application form) Submission deadline April 30th or September 30th, as applications are reviewed twice per year Applications will be processed only when all documentation has been received EDUCATIONDegree/Diploma/CertificateInstitutionDates EMPLOYMENTPresent Employment:Title of Position:Nature of Work: EXPERIENCE IN FAMILY EDUCATIONHow many years in field?Number of years leading groups?Work experience in related fieldsProfessional associations family education training Includes lectures, workshops, seminars, courses related to each of the following eight area (see About CCFE 3(b) for detailed descriptions). If one course/workshop fits under multiple categories, estimate number of hours allocated to each category. In one to two areas where specific training is lacking, candidates may submit a short, typed essay (max. 5 pages) based on independent study in that area. Essays will not be considered sufficient for education in group process and program planning. Note: Additional lines can be added to each boxed section using the TAB key. AN ORIENTATION TO FAMILY EDUCATION (also known as Family Life Education)Lecture/Seminar/Workshop/Course with Facilitator Name (if possible)DatesLocationDuration (hrs)123 INDIVIDUAL LIFE STAGE DEVELOPMENT and/or FAMILY DEVELOPMENTLecture/Seminar/Workshop/Course with Facilitator Name (if possible)DatesLocationDuration (hrs)123 FAMILIESLecture/Seminar/Workshop/Course with Facilitator Name (if possible)DatesLocationDuration (hrs)123 HUMAN SEXUALITYLecture/Seminar/Workshop/Course with Facilitator Name (if possible)DatesLocationDuration (hrs)123 INTERPERSONAL RELATIONSHIPSLecture/Seminar/Workshop/Course with Facilitator Name (if possible)DatesLocationDuration (hrs)123 VALUES EDUCATIONLecture/Seminar/Workshop/Course with Facilitator Name (if possible)DatesLocationDuration (hrs)123 GROUP PROCESSLecture/Seminar/Workshop/Course with Facilitator Name (if possible)DatesLocationDuration (hrs)123 PROGRAM PLANNINGLecture/Seminar/Workshop/Course with Facilitator Name (if possible)DatesLocationDuration (hrs)123 LEADING GROUPS Indicate practice in the field, which can include supervised student experience (i.e. interships and practica). A minimum of 150 hours is required for CCFE designation. Do not include prep time hours. Note: Use TAB key to create additional lines. Name of Group/WorkshopDatesLocationHours (not prep time) TOTAL HOURS DECLARATION I, (INSERT NAME) , certify that the information provided in this application is accurate and complete to the best of my knowledge and belief. I understand that any Certification granted to me by the Canadian Association of Family Resource Programs (FRP Canada) does not in and of itself imply or specify licensure to practice Family Education for a fee, monetary or otherwise. If I am granted Certification by FRP Canada and practice as a private practitioner, I do so at my own risk. I hereby release FRP Canada for any and all liability and/or claims that may rise from any decision to practice privately as a Certified Canadian Family Educator. I also understand that Certification depends upon my fulfillment of all required criteria for Certification. For research and statistical purposes only, data resulting from my participation in this process may be used in an unidentifiable manner. I understand that all material accompanying this application becomes the property of FRP Canada upon receipt and that neither originals nor photocopies will be returned to me. If I am granted Certification by FRP Canada, I will abide by the Certified Canadian Family Educators Code of Professional Conduct (found at  HYPERLINK "http://www.frp.ca/CCFE" www.frp.ca/CCFE). Applicants signatureDateName application checklist Please refer to About CCFE document ( HYPERLINK "http://www.frp.ca/CCFE" www.frp.ca/CCFE) for details on paragraph and sample outline requirements. 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t0644 layt $$Ifa$gd $Ifgd FJwi$$Ifa$gd $Ifgd/+}kd,C$$Ifl0 $!J t0644 layt JLwi$$Ifa$gd $Ifgd }kdC$$Ifl0 $!J t0644 layt X\wi$$Ifa$gd $Ifgd }kdfD$$Ifl0 $!J t0644 layt \^wi$$Ifa$gd $Ifgd }kdE$$Ifl0 $!J t0644 layt 8wl^$$Ifa$gd $IfgdQ $Ifgd }kdE$$Ifl0 $!J t0644 layt p t wi$$Ifa$gd $Ifgd }kd=F$$Ifl0 $!J t0644 layt t v wi$$Ifa$gd $Ifgd }kdF$$Ifl0 $!J t0644 layt  l!p!wi$$Ifa$gd $Ifgd }kdwG$$Ifl0 $!J t0644 layt p!r!!!wi$$Ifa$gd $Ifgd }kdH$$Ifl0 $!J t0644 layt !!VZwi$$Ifa$gd $Ifgd }kdH$$Ifl0 $!J t0644 layt nal copies of complete application package%     APPLICATION FORM Certified Canadian Family Educator (CCFE) Canadian Association of Family Resource Programs (FRP Canada) 707-331 Cooper St., Ottawa Ontario K1Y 2C1 Z\^bdhjnptv{qoqoqoqoe $a$gdCF dgdCFgdBh}kdNI$$Ifl0 $!J t0644 layt vxz C D h i x y z ͶͶxvx]x]F]9h]e6CJOJQJaJ,h2jh]e0J6B*CJOJQJaJph1jh2jh]e6B*CJOJQJUaJphU(h2jh]e6B*CJOJQJaJphh]e"h|h]e5:CJOJQJaJ%hYh]e5:>*CJ OJQJaJ -hYh]e5>*CJ OJQJaJ mHnHu-hYh]e5>*CJ(OJQJaJ mHnHu6jhYh]e5>*CJ(OJQJUaJ mHnHu   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