Post-Approval Request Form Core Competencies of a VR/VE Professional Full Name* CVRP Certification(s) and Number* Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Personal Phone* Work Phone* Email* Title of Education Session* Please provide link to education session if available.* Date of Education Session* MM DD YYYY Sponsor for Education Session* Sponsor Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Sponsor Email* Education Platform/Category* Conference Workshop or Seminar Symposium On-line Webinar On-line Education Module Education Presentation at Workplace or In-service Training Develop a Professional Presentation (2 CEU’s per hour presentation) Service as a Board of Committee Member Correspondence Course or Approved Home Study College Course University Course Curriculum Development for VR/VE Course Supervise/Mentor VR/VE/Career Counselling Student/Provisional Registrant Technology VR/VE Computer Application Training Editorial Review of a Recognized VR/VE Counselling Publication Research VR/VE and/or Career Counselling/Placement Development of Legislation or Regulation 1 CEU per hour of Study/Service VR or VE The number of Continuing Education Units anticipated Please indicate if submitted program covered Vocational Rehabilitation and/or Vocational Evaluation Domains of Learning. Vocational Rehabilitation Vocational Evaluation Please indicate the Vocational Rehabilitation focus areas covered in program, if applicable. 01 Vocational Rehabilitation Theory and Practice 02 Aspects of Disabilities 03 Vocational Interviewing and Counselling 04 Role of Assessment and Assessment Procedures in Vocational Rehabilitation 05 Diversity and the Vocational Rehabilitation Professional 06 Job Development and Placement 07 Case Management and Disability Management 08 Professional Conduct and Ethical Practice 09 Communication and Record Keeping 10 Supervision/Mentoring of Provisional Registrant/VR Student 11 Volunteer Credits/Other Volunteer Credits 12 Development/Presentation of VR Education/Publications 13 Other Professional Development VR Focus Areas 1 to 13 Focus Area 11- Volunteer Credits/Other Volunteer Credits Focus Area 12-Development/Presentation of VR Education/Publications Focus Area 13-Other Professional Development 1. A Published, Peer Review Article – 15 CEUs; A Published Book Chapter – 30 CEUs; A Published Book – 50 CEUs 2. 15 CEUs for one Semester Credit; 10 CEUs for one Quarter Credit 3. 10 CEUs for each Semester; 7 CEUs for each Quarter 4. 15 CEUs per Review 5. 50 CEUs for each Study Guide Please indicate the Vocational Evaluation focus areas covered in program, if applicable. 01 Foundation of Vocational Evaluation 02 Principles of Vocational Evaluation 03 Test/Tool Selection in Vocational Evaluation and Assessment 04 Transferable Skill Analysis and Employability Skills 05 Occupational Information 06 Ethics 07 Disability 08 Communication 09 Supervision/Mentoring of Provisional Registrant/VE Student 10 Volunteer Credits/Other Volunteer Credits 11 Development/Presentation of VE Education/Publications 12 Other Professional Development Vocational Evaluation focus areas 1 to 12 Focus Area 11- Volunteer Credits/Other Volunteer Credits Focus Area 12-Development/Presentation of VE Education/Publications Focus Area 13-Other Professional Development 1. A Published, Peer Review Article – 15 CEUs; A Published Book Chapter – 30 CEUs; A Published Book – 50 CEUs 2. 15 CEUs for one Semester Credit; 10 CEUs for one Quarter Credit 3. 10 CEUs for each Semester; 7 CEUs for each Quarter 4. 15 CEUs per Review 5. 50 CEUs for each Study Guide Describe the learning goals or expected outcomes below. What were the instructional methods used and time devoted to each method? Please describe if there were any follow-up procedures, out of session or home assignments. Please provide any other relevant program information below. Education/Program Description/Agenda Please upload the education/program description/screen shot/agenda if available. Presenter(s) Profile/CV Other Please upload any other documentation relevant to program. Other Please upload any other documentation relevant to program. Other Please upload any other documentation relevant to program.
