Fillable Application Form for the Individual Assessment of Educational (College of Early Child Educators)

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Application Form for the Individual Assessment of Educational (College of Early Child Educators)

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Country of origin: CANADA
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Date (dd/mm/yy)
Applicant’s full name
I confirm that all the information contained in this Application Form for the Individual Assessment of
Educational Qualifications and related documents is true.
I acknowledge that any false or misleading statement, representation or declaration in or in
connection with this application, may be cause for refusal of registration or disciplinary action.
By checking this box and typing/printing my name I confirm my understanding and agreement to
the terms of this Application Form.
438 University Avenue, Suite 1900
Toronto ON M5G 2K8
Telephone: 416 961-8558
Toll-free: 1 888 961-8558
E-mail: registration@college-ece.ca
Website: college-ece.ca
Application Form for the Individual Assessment of Educational
Qualifications
To complete this form, you must download and save a blank copy to your computer. Close your Internet
browser and open the saved copy from your computer files. Now you may print off a hard copy or enter
your information electronically.
Application for Individual Assessment Information
This form is for individuals who require an individual assessment of their educational qualifications.
Individuals who are former members and have had a Certificate of Registration revoked but had formerly applied
under the individual assessment process must also use this form.
Please see college-ece.ca/individual_assessment_guide to confirm that this form applies to you.
Section 2: Previous Applications
a) Have you previously applied for registration with the College of Early Childhood Educators?
Yes No
If yes, please provide the following information:
• Application reference number:
• First and last name you applied under:
b) Are you a former member of the College whose Certificate of Registration was revoked?
Yes
No
If yes, please provide your registration number:
Section 1: Confirmation of Applicant’s Understanding
Confirm your understanding by putting a check markby each of the 3 statements below.
CECE – Application Form for Individual Assessment – 2020
Page 1 of 11
Section 3: Application Package
All applicants must submit the following items in their application package to the College:
a) Signed and completed Application Form
b) Payment of C$245 (new applicants) or C$255 (former members)
Any application package missing one or more of the above items will not be processed by the College and
will be returned. See college-ece.ca/individual_assessment_guide for details.
Applicants: You must submit additional supporting documents. See college-ece.ca/
individual_assessment_guide for details and instructions.
I have never been registered with the College – Fee due is $245 ($85 application fee + $160
registration fee)
I am a former member who is re-applying to the College and the current status of my Certificate
of Registration is cancelled / resigned / expired - Fee due is $245 ($85 application fee + $160
registration fee)
I am a former member who is re-applying to the College and the current status of my Certificate of
Registration is revoked – Fee due is $255 ($95 application fee + $160 registration fee)
Please check method of payment being submitted:
Cheque/ money order/ bank draft made out to the College of Early Childhood Educators
Cheque/ money order/ bank draft number:
Amount C$
Visa Visa Debit MasterCard
By checking this box and typing/printing my name I authorize the College to charge the
credit card below in the amount of C$ .*
Cardholder’s name: (please print as it appears on the credit card):
Card number:
Exp. date (mm/yy):
CVV number (Card Verification Value) – The 3 digit number located on the back of the
credit card:
Section 4: Application and Registration Fees
Please note the different application fees below.
Please check the description below and the corresponding fee (in Canadian dollars) that applies to you:
*The application fee and the registration fee will appear as two separate transactions on your credit card statement.
CECE – Application Form for Individual Assessment – 2020
Page 2 of 11
R.R.
Postal Code
City
Country
b. Business telephone number (include area code)
c. Business fax number (include area code)
Section 5: Personal Information (See college-ece.ca/individual_assessment_guide)
Last name First name
Middle name(s)
Common first name (as it will appear on the College’s public register)
Last name at birth (if different from above)
First name at birth (if different from above)
Former last name (if changed)
Former first name (if changed)
Date of birth (dd/mm/yyyy)
Home street address
Unit #
R
.R.
P.O. Box
City
Province/Territory/State
Postal Code
Country
Home telephone number (include area code)
Mobile telephone number (include area code)
Preferred e-mail address (please include an e-mail address that is accessed only by you in order to
receive communications from the College):
Are you currently: Employed Unemployed
If you checked the box to indicate you are employed, please provide the following:
a. Place of employment
Business name
Business address:
Unit #
Province/Territory/State
P.O. Box
CECE – Application Form for Individual Assessment – 2020
Page 3 of 11
Indigenous heritage Francophone
Section 6: Eligibility to Work in Canada
Please submit a copy of proof of eligibility to work in Canada: Canadian birth certificate,
valid passport, or valid work permit. For a full list of documents, please see college-ece.ca/
individual_assessment_guide.
Yes, I am eligible to work in Canada.
For applicants with a work permit only: If you have a valid work permit and meet all of the registration
requirements, the College will issue a certificate with Terms, Conditions or Limitations (TCL
s) being
placed on your Certificate of Registration as outlined at college-ece.ca/individual_assessment_guide.
Please confirm your consent below.
By checking this box and typing/printing my name below, I consent to have the following TCL
imposed on my Certificate of Registration and I agree to submit a copy of my work permit to the
College.
I agree to provide proof of continued authorization under the Immigration and Refugee Protection
Act (Canada) to engage in employment within the practice of the profession, failing which the
certificate will expire on (date of expiry of current work permit).
Applicant's full name
Section 5: Personal Information cont'd
Communications from the College
Preferred mailing address for communications from the College
Home address Business address
English French
Preferred language of communication from the College:
For statistical purposes only
I identify my gender as: Female Male
If neither term above applies to you, please check this box.
Optional: I choose to self-identify with any of the following:
CECE – Application Form for Individual Assessment – 2020
Page 4 of 11
Section 7: Educational Requirement (see college-ece.ca/individual_assessment_guide)
Complete the one section that applies to you. List all credentials that you would like the College to
consider in your assessment. If you have more than three credentials, use the “Additional Information
Sheet”.
a) If you obtained a diploma or degree in Canada then fill out the following:
Name of diploma program or degree
(indicate major):
Name your transcript will appear under:
Educational institution name and address
(include city and province):
Official transcript ordered on (dd/mm/yyyy):
Year graduated:
Student number:
Name of diploma program or degree
(indicate major):
Name your transcript will appear under:
Educational institution name and address
(include city and province):
Official transcript ordered on (dd/mm/yyyy):
Year graduated:
Student number:
Name of diploma program or degree
(indicate major):
Name your transcript will appear under:
Educational institution name and address
(include city and province):
Official transcript ordered on (dd/mm/yyyy):
Year graduated:
Student number:
1)
2)
3)
CECE – Application Form for Individual Assessment – 2020
Page 5 of 11
b) If you obtained a diploma or degree outside of Canada, you are required to apply to WES for an
ICAP Evaluation Report. Fill out the following:
Name of diploma program or degree
(indicate major):
Year graduated:
Educational institution name and address
(include city and country):
1)
2)
3)
WES ICAP report ordered on (dd/mm/yyyy):
The name your WES ICAP report will appear under:
WES application reference number:
Section 8: Language Fluency
Check the box that applies to you.
The language of instruction for my diploma or degree was in English.
The language of instruction for my diploma or degree was in French.
Other - The language of instruction for my diploma or degree was in a language other than English
or French.
If you answered "Other" to the above, you must complete an English or French language test that
has been approved by the College and achieve the scores required by the College for that test.
Check the box below to indicate which language test will be submitted:
International English Language Testing System (IELTS) Academic: Minimum score of 6.5 in
each category (speaking, listening, reading and writing).
Internet-based Test of English as a Foreign Language (IBT TOEFL): Overall score of 88 and a
minimum score of 20 in each category (speaking, listening, reading and writing).
Canadian Test of English for Scholars and Trainees (CanTest): Minimum score of 4.0 in each
category (speaking, listening, reading and writing).
Test pour étudiants et stagiaires au Canada (TestCan): Minimum score of 4.0 in each category
(speaking, listening, reading and writing sections).
See college-ece.ca/individual_assessment_guide for instructions about submitting test results.
Section 7: Educational Requirement cont'd (see college-ece.ca/individual_assessment_guide)
CECE – Application Form for Individual Assessment – 2020
Page 6 of 11
Section 9: Professional Registration (Licensure)
You must answer ALL of the questions in this section.
1. Are you currently registered/licensed, or have you ever been registered/licensed by another
regulatory/licensing organization in any profession in any jurisdiction?
Yes No
If you answered “yes” to the above, you are required to arrange for a Proof of Professional Standing Form
to be sent from the regulatory organization to the College and provide the following information. See
college-ece.ca/individual_assessment_guide for further details on the additional steps required.
Name of the profession(s)
Name of regulatory/ licensing organization
Province/Territory/State
Country
Dates of registration
Date you requested the Proof of Professional Standing Form
from the regulatory/licensing organization (dd/mm/yy)
If you are or were registered or licensed in more than one jurisdiction or profession, see college-ece.ca/
individual_assessment_guide for how to provide more details on the “Additional Information Sheet”.
2. Have you ever been refused registration or membership by a regulatory/licensing body?
Yes No
If you answered “yes” to the above, see college-ece.ca/individual_assessment_guide for
further details on the additional steps required and fill out the following.
Name of the profession(s)
Name of regulatory/ licensing organization
Province/Territory/State
Country
Dates applicable
CECE – Application Form for Individual Assessment – 2020
Page 7 of 11
Section 10: Issues Potentially Affecting Practice
You must answer ALL of the questions in this section.
1. Have you ever resigned your membership or registration with a regulatory/licensing organization while
you were the subject of a complaint, inv
estigation or proceeding with respect to professional
misconduct, incompetence or incapacity in the practice of early childhood education or any other
profession (in any jurisdiction)?
2. Have you ever been found guilty of professional misconduct, incompetence or incapacity in the
practice of early childhood education or any other profession (in any jurisdiction)?
3. To your knowledge, are you currently being investigated for professional misconduct, incompetence or
incapacity, in the practice of early childhood education or any other profession (in any jurisdiction)?
4. Have you ever been charged and/or found guilty of an offence under the Controlled Drugs and
Substances Act
(Canada) or the Food and Drugs Act (Canada)?
5. Have you ever been charged and/or found guilty of a criminal offence in Canada or in any jurisdiction
outside of Canada?
6. Do you have a mental condition or disorder that may affect your ability to practise the profession
safely?
7. Have you ever been charged with misconduct, including academic misconduct, that resulted in
disciplinary actions by the Dean’s office (or any equivalent or higher administrative office) while you
attended a post-secondary institution?
ECE removed?
11. Do you currently hold, or have you ever held a licence to operate a child care centre under the Day
Nurseries Act or the Child Care and Early Years Act?
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
CECE – Application Form for Individual Assessment – 2020
Page 8 of 11
Section 10: Issues Potentially Affecting Practice cont’d
You must answer ALL of the questions in this section.
Yes No
8. Has a Children’s Aid Society or equivalent authority in any jurisdiction ever verified allegations
or concerns made against you?
9. Hav
e you ever had a Director’s Approval for you to work in the role of an ECE or as a supervisor in
an ECE
setting removed?
Yes No
11. Do you currently hold, or have you ever held a licence to operate a child care centre under the
Day Nurseries Act or the Child Care and Early Years Act?
Yes No
If you answered "Yes” to question 11, answer the following:
a. Have you ever been found guilty of an offence under the Day Nurseries Act or the Child Care
and Early Years Act or are you currently being investigated for an offence under either of those
Acts?
Yes No
b. Has a Director appointed under the Day Nurseries Act or the Child Care and Early Years Act
ever revoked or refused to renew your child care centre licence?
Yes No
If you answered “Yes” to any of the questions in section 10, see college-ece.ca/
individual_assessment_guide for instructions on providing
more detailed information
and attach additional documents.
10. Have you ever had a letter of permission to work in a full-day kindergarten program in the role of
an ECE removed?
Yes
No
CECE – Application Form for Individual Assessment – 2020
Page 9 of 11
a) I understand that I must hold a Certificate of Registration in good standing with the College of
Early Childhood Educators (the College) in order to practise as an early childhood educator in
Ontario.
Yes
b) I understand that I cannot use the protected titles or designations “early childhood educator”
(ECE) or “registered early childhood educator” (RECE) or their French equivalents unless I hold
a Certificate of Registration in good standing with the College.
Yes
c) I understand that the College may require additional information (including supporting
documents) in connection with this Application Form.
Yes
d) I understand that if there are any changes to the information provided on this Application Form,
including to my contact information and changes to my eligibility to work in Canada, I am
required to notify the College within 30 days of that change using the Change of
Information Form.
Yes
I confirm that I have read and agreed with all of the above conditions and verify all information in
this Application Form is authentic and true.
Yes
Review and Finalize Your Application
Please review this form and ensure it is complete and true before submitting it with supporting documents
(if appropriate). See instructions at college-ece.ca/individual_assessment_guide.
Your privacy matters. For more information on how we protect your data and the way it can be used, please visit college-ece.ca/privacy-statement.
Section 11: Acknowledgement
Please acknowledge by putting a check markbeside each of the 5 statements below.
CECE – Application Form for Individual Assessment – 2020
Page 10 of 11
Additional Information Sheet
CECE – Application Form for Individual Assessment – 2020
Page 11 of 11
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Completed 19 April 2021

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