Fillable 2018 CFLE Approved Program Application (Winthrop University)

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2018 CFLE Approved Program Application (Winthrop University)

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Certified Family Life Educator (CFLE)
CFLE-Approved Program Application - 2018
For recent graduates of a National Council on Family Relations (NCFR) CFLE-Approved Program
(NCFR defines “recent” as within the past two years). Go to
https://www.ncfr.org/cfle-
certification to access the CFLE-Approved Program information when you are ready to apply to ensure you have the most current
information.
Name: ____________________________________________________________________________________________
Please type or print exactly as you would like your name to appear on your certificate.
Street Address: ________________________________________________________________________Home Work
City, State/Province: ______________________________________________________ Zip/Postal Code: ____________
Phone – place a ✓ by preferred phone number
□ Work: ____________________________________
□ Home: ___________________________________
□ Mobile: ___________________________________
E-mail: ___________________________________________ Alternate E-mail: _______________________________________
Certification level: I am applying for Full Certification Provisional Certification
Full Certification is available for applicants who have recent work experience in family life education. In order to receive Full
Certification as a Certified Family Life Educator (CFLE), an applicant must document sufficient family life education work experience
activity. The number of hours of work experience needed varies depending upon the level and relevance of the applicant's degree:
Full
Certification
Bachelor’s
Level
Master’s or PH.D. Level
Complete this application
form and document FLE
work experience hours by
completing the FLE Work
Experience Summary Form
Document at least 3,200 hours FLE work
experience
Document at least 1,600 hours FLE work experience
All applicants must submit:
This Application form
Official Transcript- this must show degree completion
CFLE-Approved Program Checklist
Signed Code of Ethics
Provisional or Full Certification Fee
For Full certification, please additionally submit:
Work Experience Summary form
Work Experience supporting materials
Employment Assessment & Verification form
Current Resume/Vita
Office Use Only
___ CC
___ Check# ______
Amount $______________
Institution Major Degree Level Awarded Year
CFLE FEE
Provisional Certification - $135 (NCFR Members) or $185 (non-members).
Full Certification - $220 (NCFR Members) or $300 (non-members). This level is for applicants who meet the work
experience requirements. The fee includes the review of the Family Life Education Work Experience Summary form and
the Employer Assessment & Verification form. (See Work Experience for Full Certification for more information -
https://www.ncfr.org/cfle-certification/become-certified/work-experience-full-certification.)
Application fees are non-refundable as they are for the review of your application materials.
NCFR ID # (found on your mailing label, or by logging in to https://my.ncfr.org.) Membership
application and fee may be submitted along with the CFLE application. Please pay with separate checks if possible.
Mail completed application to:
National Council on Family Relations
ATTN: CFLE Program
661 LaSalle St. Suite 200
St. Paul, MN 55114
Payment Method - □ Check/money order □ Visa □ MasterCard □ AMEX □ Discover □ Diners Club □ JCB (Japan)
Amount $______ Credit Card Number ___________________________________ Expiration Date __________ CVC code ______
Name on Card ____________________________________________________________________________________________
Street Address ____________________________________ City ______________________ State ______ Zip Code ___________
(Please provide the mailing address associated with the credit card statement)
Signature ________________________________________________________________________________________________
U.S. funds drawn on U.S. banks only. Overpayment of $10 or less is considered a contribution. Service charge for all returned checks is $30.
Make check or money order, payable to NCFR. Membership dues are subject to change without notice. FEI 41-0762436
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2018 CFLE Approved Program Application (Winthrop University)

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Completed 23 July 2020

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