RTWDM Grandfathering Application Form

I understand that the information provided on this application will be used for purposes of admission, registration, research and development, and other purposes consistent with the mandate of the College of Vocational Rehabilitation Professionals (the College). I hereby verify that the information submitted for this application is accurate. I understand that providing false or incomplete information could result in action being taken by the College including immediate suspension of my certification of registration. I confirm that it is my obligation to notify the College within 30 days in the event that any of my information changes. I understand that submission of this application in no way guarantees my membership in the College, and that misrepresentation of this information in any way may result in cancellation of my admission or registration status. I confirm that I have never been convicted of a criminal offense, for which I have not received a pardon that is relevant to my work as a RTWDM.

I confirm that I have not been dismissed from employment or refused membership in a professional association or regulation/registration in a related field, on the grounds of professional misconduct in Canada, the United States of America or anywhere else in practice Internationally.

If accepted as an RTWDM through this grandfathering process, I agree to annually review the College Standards of Practice, Code of Ethics and By-Laws. I undertake to abide by all of the rules, regulations, standards and policies of the College of Vocational Rehabilitation Professionals (the Governing Rules and Regulations). I understand that my membership in the College of Vocational Rehabilitation Professionals (the College) is voluntary and that by becoming a member, I consent to the College acting as my professional self-regulating body. I acknowledge that my membership status in the College of Vocational Rehabilitation Professionals is based on the College’s Governing Rules and Regulations. I agree to abide by the provisions of the Governing Rules and Regulations and I recognize that the College has the right to limit or terminate my membership status under the College’s Bylaws, Policies, Standards of Practice, and Code of Professional Conduct. As a voluntary member, I hereby release the College of Vocational Rehabilitation Professionals from all liability for any act of negligence or want of ordinary care on the part of the College and or any of its agents. In consideration of my membership in the College of Vocational Rehabilitation Professionals, I waive, release, and discharge the College and their directors, officers, agents and members, their representatives, heirs, executors and assigns from any and all claims of liability. This agreement is binding upon my executors, heirs, and assigns. I hereby discharge and release from any liability, the College and its authorized representatives, for any acts, communications, or decisions regarding the processing, consideration, and maintenance of my membership application and file. I hereby declare that I have current Professional Liability (Errors & Omissions) insurance coverage. I understand that I must biennially submit proof of approved Continuing Education Units (CEU’s) and must accumulate the total number of CEU’s required to maintain my level of certification. The maintenance level for CEU’s is currently set at 20 per 2-year period. I hereby declare that the information given in this application and any documents is, to the best of my knowledge, true, correct, and complete in every respect and that I am the applicant.