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CCC Application Form (TEST)

All applicants must be a member of CCPA in order to apply for certification.
INCOMPLETE FORMS WILL NOT BE PROCESSED

CCC Application Form

"*" indicates required fields

1. Applicant Information

Name*
Address*

2. Education

Must hold graduate degree in counselling or related field
Graduate Degree(s)*
University
Year
Degree
Major
 

Graduate Degree(s)

3. Graduate-level coursework toward certification

Located on transcript(s), minimum 8 full courses

Counselling Theory (Compulsory)

Supervised Counselling Practicum/Internship (Compulsory)

Counselling and Communication Skills (Compulsory for graduates after Sept 2012)

Professional Ethics (Compulsory for graduates after Sept 2012)

3. Elective Courses

Please refer to the corresponding section in the Certification Guide

4. Documentation

All applicants must provide each of the following pieces of documentation. Please check off each document that you have prepared or intend to submit
Official Transcript
Sent to CCPA by mail in a signed and sealed envelope from the university, or emailed directly from the issuing university as a password-protected unalterable PDF document to CCPA National office. Electronic copies of the transcript from the applicant, mailed transcripts with a broken or tampered seal, any type of faxed transcripts, scanned, or photocopied versions of the official transcript will not be accepted toward certification as the authenticity of these documents cannot be verified.
Course descriptions from an official source
These must be official syllabi or course descriptions from the academic course calendar from the years that you attended your Masters of Counselling. Normally, these documents can be obtained from the university registrar's office. These documents may be photocopied or scanned and sent to us by mail or fax, or sent by email in an unalterable PDF (including URL and retrieval date information if it is saved from the official university website).Applicants who cannot obtain an official document can ask their University for archived copies. If archives are unavailable, the University must provide a letter attesting that they are no longer available in order for your application to be evaluated.
Vulnerable Sector Criminal Record Check
The original hardcopy, issued by the police within the past 12 months, must be mailed to CCPA from the applicant, or sent directly from the issuing police service by email as a password-protected unalterable PDF document. Electronic copies from the applicant, faxed documents, scanned, or photocopied versions of the check will not be accepted toward certification as the authenticity of these documents cannot be verified.

5. Pathways Documentation

All applicants must apply based on either Pathway ONE or Pathway TWO.
PATHWAY ONE: For applicants who graduated within the last five years. Education and Practicum Training
CCC Practicum Form(s)
One form per practicum placement. Altogether the forms must attest to a total of 150 hours of direct client counselling.
TWO CCC Reference Forms
Must be completed by a graduate-level counsellor, counsellor-educator, or counselling supervisor. The individual must be someone in a non-compliant relationship with you.
OR
PATHWAY TWO : For applicants who graduated over five years ago. Education and Work Experience
CCC Work Experience Form(s)
One form per employer/workplace. In total, attesting to 800 hours of direct client counselling (the equivalent of 3 years of practice) within the last five years from the date of their application.
Current résumé
TWO CCC Reference Forms
One of which must be completed by a clinical supervisor who has engaged in formal supervisory activities according to CCC criteria and can speak to the applicant's competencies. Forms must be completed by a graduate-level counsellor, counsellor-educator, or counselling supervisor. The individual must be in a noncompliant relationship with you who knows you in your capacity as a counsellor within the past ten years.

6. Attestation

Please read carefully for important information regarding your application
I certify that the information provided in this application is accurate and complete to the best of my knowledge and belief. I understand that the outcome of my application depends upon my demonstration of how my application satisfies the required criteria, including presenting relevant coursework in Section 3 for consideration by the Registrar. I will practice in accordance with CCPA's Code of Ethics. I have included a valid criminal records check with vulnerable sector screening conducted within the last 12 months or will submit one to CCPA shortly. I understand that any certification granted to me by the Canadian Counselling and Psychotherapy Association does not in and of itself specify licensure to practice counselling for a fee, monetary or otherwise. If I am granted certification by CCPA and practice counselling as a private practitioner, I do so at my own risk. I hereby release CCPA from any and all liability and/or claim that may arise from any decisions to practice privately as a Canadian Certified Counsellor. 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 becomes the property of CCPA upon receipt and that the official versions of my transcript and vulnerable sector criminal record check will be destroyed 12 months after I receive the Registrar's outcome. If I want these documents back, I understand that I must request to have them sent free of charge prior to the end of this timeframe.
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7. Payment

Payment can be made online by logging into the Member Portal at https://members.ccpa-accp.ca.
The total cost for certification is $170 ($95 for application plus $75 annual fee). The $75 annual fee will be reimbursed if your application is not granted CCC.

Please note an invoice with be generated once your CCC Application has ben processed. Please allow 3 to 5 business days for processing of documents.