Recsandpark.files.wordpress.com



California Board of Recreation and Park Certification, IncCalifornia Certification, established in 1954, Promotes Pride and Excellence in the ProfessionP.O. Box 2137 Fallbrook, CA 92088 V/M: 661-538-1332 Web site: email: cbrpcca@ Date: September 2020To: RTC’s who paid and received an RTC Extension from June/December 2019 Renewal Cycles Subject: 2020 EXTENSION RENEWAL NO FEE IS DUE, You already paid for it last year.The results from the CBRPC Recertification Review Committee will be mailed out after the committee completes review of all renewals. If there is a concern/question with your renewal the committee person, reviewing your renewal, will contact you for clarification and/or additional information so please be sure to include a valid phone number. Once the renewal is approved, begin earning your next 2.0 CEU’s which must fall within June or December 1, 2020 to June or December 1, 2022 when your 2022 Renewal comes due.EXPEDITE THE RENEWAL PROCESS: 1) Complete all information on all related forms (pages 3-10), leave nothing blank2) Attach copies of your CEU’S in the order listed on your form/ Contact hours must fall within the two years of your last renewal. 3) List (yes, you do have to list each one) all the CEU’S/Contact hours and in same order you received them.4) Complete and return by the deadline date.5) Incomplete/ missing form(s) will delay the renewal processEXTENSION RENEWAL received after December 1, 2020 are expired and you will be required to complete the Previously Certified RTC Previously Certified Re-entry Application which can be found on the website Mail renewal (pages 3-10) forms to: CBRPC P.O. Box 2137 Fallbrook, CA 92088 or scan and attach to an email to: cbrpcca@ or cbrpc@) CEU’s /Contact hours earned must relate to the profession2.0 CEU’S or 20 Contact hours MUST FALL WITHIN 2018-2020 (June or December Cycle)1 contact hour = 0.1 CEU. 10 contact hours= 1.0 CEU 20 contact hours= 2.0Attach copies of CEU documentation and then put in order of how they are listed on the re-certification formCEU/CONTACT HOUR CERTIFICATE/VERIFICATION FORM TO INCLUDE THE FOLLOWINGLocation/Date/Time/Name of Provider of workshop/institute/conference and CEU Provider # Your name on each of your CEU documents/certificates with number of CEU’S/Contract hrs awardedSession title/ Length of each session (1 hr/ 1.5 hrs/ 2 hrs/ 3 hrs etc.)Verifying signature required (monitor/person sponsoring the workshop/institute)CEU /CONTACT HOUR CONTENTSAFETY Related Courses cannot exceed .5 CEU’s. (i.e., CPR, FA, PRO ACT, CPI, Food Handlers & Safety Courses, MAB, Water Safety, Fire Safety, Back Safety, Basic Infection Control, Disaster Emergency Triage, etc).Correspondence and ON-LINE LEARNING Courses 2.0 CEU or 20 contact puter Skills Courses limited to 0.5 CEU’S/or 5 contact hours.Language Courses limited to1.0 CEU/or 10 contact hours.***Safety courses, computer skill courses and work required training courses (unless recreation therapy course) will no longer be acctepted after deecember 2020CEU’s/CONTACT HOURS for WRITTEN PUBLICATIONS (books, articles, thesis, dissertations) Approved author of current published text book/ Thesis & Dissertation during the 2-year cycle. Limit 1.0 CEU’s or 10 contact hours. Authored published articles (co-author not accepted) in professional magazines or newspapers related to the field during the cycle may not exceed .2 CEU’s or 2 contact hours.Proof must be submitted and applied once.CEU’s EARNED for PRESENTING at a WORKSHOP or as a GUEST LECTURERAwarded to solo speakers onlyMinimum length 1 hour/ maximum length 3 hours. You will be awarded half the number of CEU’s for the presentation; example 1 hour= .05 2 hours= 0.1 3 hours= 0.15 4 hours= 0.2Repeating sessions or topics are not accepted during each 2-year cycle Must have written proof to include; date, time, location, number of hours, topic title, verified signature (Not your signature)CBRPC THERAPEUTIC RECREATION 8 KNOWLEDGE AREAS1.Administration & Management2. Disability/Population Characteristics3. Documentation4. Legislation/ Patient/Consumer Rights5. History & Philosophy6. Professionalism7. Programming8. Treatment ModalitiesCOMPLETED COLLEGE/UNIVERSITY COURSES, attach a copy of the transcript to verify course work and final grade/audit credit & course title. Course work must relate to the therapeutic recreation field. California Board of Recreation and Park Certification, Inc 2020 RTC EXTENSION RENEWAL FORMS Print/Type and complete ALL informationCERTIFICATION NUMBERSDATE OF BIRTHRTC# -T & or RC# Month: Day: Year: ADDITIONAL CERTIFICATIONSCURRENTLY EMPLOYED IN THE FIELD?Additional Current Certifications- check all that apply: FORMCHECKBOX CTRS FORMCHECKBOX CPRP Are you currently employed in the field? FORMCHECKBOX Yes FORMCHECKBOX No, briefly explain:Employed in the field; check all that apply FORMCHECKBOX Per Deim FORMCHECKBOX Part-time FORMCHECKBOX Full-time (30+ hours a week) FORMCHECKBOX Clinical Setting FORMCHECKBOX Community Setting How many years have you worked in the field of Therapeutic Recreation/Recreation Therapy? PRESENT JOB TITLE Check which applies to your current position: FORMCHECKBOX Therapist FORMCHECKBOX Supervisor FORMCHECKBOX Management/ Administration FORMCHECKBOX Educator FORMCHECKBOX Self-Employed FORMCHECKBOX Retired FORMCHECKBOX Unemployed FORMCHECKBOX Other; briefly explainCHECK ALL THAT APPLY: FORMCHECKBOX Mr. FORMCHECKBOX Mrs. FORMCHECKBOX Ms. FORMCHECKBOX Dr FORMCHECKBOX PhD FORMCHECKBOX Ed. D FORMCHECKBOX other: explain Has your last name changed since 2019? FORMCHECKBOX No FORMCHECKBOX Yes; previous last name:CURRENT LAST Name: FIRST Name: Middle Initial:CURRENT Mailing Address: Apt/Unit/Space #City & State Zip Code: Include area codes Home: Cell: Fax:PREFERRED Email: Mailing address changed since 2019? FORMCHECKBOX No FORMCHECKBOX YesGender _____Male ____Female _____Other RTC INCOME: check current (approximate) hourly rate of pay. (How to calculate: take bi-monthly or monthly gross income and divide it by the number of hours you worked for that pay period and you will get your hourly rate of pay) Volunteer$21-24$35-39$50-54$65-69$85-89$95-99$10-14$25-29$40-44$55-59$70-74$75-79$100$15-20$30-34$45-49$60-64$80-84$90-94$125 + DECLARATION: I have read over the directions and hereby declare the information contained and any attachments are accurate and true.Signature: Date: California Board of Recreation and Park Certification, Inc 2020 RTC EXTENSION RENEWAL EARNED CEU’S Contact Hours / CEU’s from 2018 -2020Print clearly and complete all informationCertificant’s Full Name: Employer:Client/Consumer Populations Served (check all that apply)AbusedEating DisordersMental Health ConditionsPublic School StudentsAcute CareHead Trauma/InjuryOncologySex OffendersAged (Alzheimer’s, Dementia)HI/DeafPediatricsSexually Transmitted DiseasesBlind/ Visual ImpairmentsHomeless Streets/ SheltersPrisons/Detention CentersSpecial Education StudentsCollege/University StudentsHospicePhysical Disabilities/ Rehab.Substance AbuseCVAIntellectual & Developmentally DisabledPost-Traumatic Stress DisorderYouth at RiskLIST ALL WORSHOPS/INSTITUTES/CONFERENCE COURSES Unlimited CEU’sTitle of SessionCEU Provider Name & orID#DateLength Of SessionCBRPCKnowledgeArea CodeNumberof CEU’sAwardedRRCUSELIST ALL LANGUAGE COURSES Limited 1.0 CEU’s or 10 contact hours no matter how many were earnedTitle of CourseCEU Provider Name & orID#DateLength Of SessionCBRPCKnowledgeArea CodeNumberof CEU’sAwardedRRCUSELIST ALL CORRESPONDANCE/ ON-LINE/ WEBINARE COURSES 2.0 CEU’s or 20 contact hoursTitle of SessionCEU Provider Name & orID#DateLength Of SessionCBRPCKnowledgeArea CodeNumberof CEU’sAwardedRRCUSELIST ALL SAFETY RELATED COURSES Limited .5 CEU’s/5 contact hours no matter how many were earnedTitle of CourseCEU Provider Name & orID#DateLength Of SessionCBRPCKnowledgeArea CodeNumberof CEU’sAwardedRRCUSELIST ALL COMPUTER SKILLS COURSES Limited .5 CEU’s/ 5 contact hours no matter how many were earnedTitle of Course# of unitsCEU’sDates of courseInstructors Full NameCBRPCKnowledgeArea CodeRRCUSELIST CEU’S EARNED AS A SPEAKER at a workshop/institute/ conference or guest lecturerAwarded to solo speakers only. Awarded half the number of hours of the presentation; minimum 1 hour and maximum 4 hours Example of what will be awarded: 1-hour presentation = .5 CEU’s 3-hour presentation= 0.15 CEU’s 4-hour presentation= 0.2 CEU’s- must provide written proof.Title of SessionDate ofsessionLocation# of hrs.RRCUSECEU’S EARNED FOR YOUR WRITTEN PUBLISHED PUBLICATIONS books, articles, thesis, dissertations related to the recreation therapy field Approved author of current published text book/ Thesis & Dissertation during the 2-year cycle limited to 1.0 CEU’s or 10 contact hours. Authored published articles (co-author not accepted) in a professional magazine or newspaper related to the field during the 2-year cycle and may not exceed .2 CEU’s or 2 contact hours. Proof of said publications must be submitted and can be applied only once during the 2-year cycle.Title of Textbook/ Thesis/ ArticleDate of publicationTextbookArticleThesisPublisherRRCUSELIST UNIVERSITY/COLLEGE COURSE WORK Unlimited CEU’s must relate to field & attach an official transcript of completed courseTitle of Course# of unitsCEU’sDates of courseInstructors Full NameCBRPCKnowledgeArea CodeRRCUSE RTC 2020 EXTENSION PAYMENT FORMMust be completed and return with form(s)FEES for payment with a Check or Money OrderCheck that applyAmountRTC Extension Fee ////$ 200.00RTC Extension LATE FEE After December 1, 2020$ 245.00FEES for payment with a Credit Card RTC Extension Fee $ 205.00RTC Extension LATE FEE After December 1, 2020$ 250.00 RTC Replacement Certificate Fee$ 30.00 CBRPC Lapel Pin$ 8.00 Tax Deductible Donation to CBRPC, Inc Non-Profit- 501(c)(3)$ Total Amount Enclosed$PAYMENT INFORMATIONCheck here for payment with check/money order/ Cashier’s check #Check enclosed Check/MO/Cashier’s Check # : Make check payable to: CBRPC PAYING BY CREDIT CARD; check which credit card you are using and all information below FORMCHECKBOX or FORMCHECKBOX Credit Card Number: - - -Credit Card Expiration Date:Cardholder Printed Name:Cardholder Signature:Cardholder BILLING Address/City/ State: __________________________________________________________________________Cardholder phone number & area code:Email:Date of completion: Paying by credit card- Forms & Payment: 1) mail to address below, or SCAN and 2) email cbrpcca@ as attachment or Paying by check/money order/cashier’s check- mail payment and forms to: CBRPC, Inc PO Box 2137 Fallbrook, CA 92088 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download