Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 1 of 12
1850 Sun Life Place
10123 - 99 Street NW
Edmonton, AB T5J 3H1
Phone: (780) 424-5070
Toll Free: 1-800-659-0857 (in Alberta)
Fax: (780) 420-1241
credentials@cap.ab.ca
www.cap.ab.ca
Application for Evaluation of Academic Credentials Pathways 1 and 2
If you completed a CPA/APA accredited doctoral program or a CAP approved program, complete the
Application for Evaluation of Academic Credentials Pathways 3 and 4. Otherwise, complete this form.
The College of Alberta Psychologists (CAP) must receive the following on or before the posted deadline
date in order to process your application for the next scheduled meeting:
Transcripts, letters, and syllabi must be received directly from the issuing institution. The application and
any transcripts, letters, or syllabi must be original documents mailed directly to CAP. Faxed or emailed
documents are not accepted.
Required:
completed application
notarized Statutory Declaration form
completed Academic Credentials form
non-refundable application fee as per fee schedule
official transcripts
If applicable:
thesis/doctoral dissertation abstract
official letters
official course syllabi/outlines
academic credentials of faculty, including their area of specialization
Specialized Assessment of coursework from International Qualifications Assessment Service (IQAS) or
Course-by-Course Assessment of coursework from World Education Services (WES) Canada
IELTS Test Report Form
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 2 of 12
Information
1.
The application must be typed and submitted as a single-sided document.
2.
You will be informed by email, prior to the meeting date, of the status of your application.
3.
The Credentials Evaluation Sub-Committee (CESC), an adjudicative committee of CAP, evaluates the
academic credentials of applicants. You will be informed of the committee’s decision, by email, within
four weeks of the review date.
4.
Official transcripts must arrive on or before the deadline date of the corresponding meeting. All meeting
dates and deadlines are posted on CAP’s website.
5.
If you received transfer credit for any courses, official transcripts must be submitted for the institution
where the courses were originally completed.
6.
If the program requirements (coursework, projects, thesis/dissertation defense, practicum) are complete
but the graduate degree has not been officially granted (not recorded on transcript), an official letter
must be mailed directly from the academic institution confirming the completion of all degree
requirements and the expected convocation date.
7.
Official course syllabi and instructor credential information must be provided if coursework being listed
does not state “psychology” in the title or prefix or is not from a program of psychology. If providing course
syllabi, they must be from the year and session/term the course was completed and mailed directly from
the institution to the College.
8.
The Statutory Declaration must be signed by a Commissioner for Oaths, Justice of the Peace or Notary
Public.
9.
Application fees are based on the origin base of the institution and not the location of the campus where
the degree was completed.
10.
If you attended an institution outside of North America, you must obtain a Specialized Assessment of
coursework from IQAS or Course-by-Course Assessment from WES Canada.
11.
If your transcripts are in a language other than English, they must be translated into English by a certified
translator and notarized.
12.
If you have more coursework to list, print and attach additional pages.
13.
Internationally educated applicants applying for registration in Alberta must provide evidence of English
language proficiency.
a.
Internationally educated applicants are exempt from taking the English language proficiency
testing if:
their highest degree was obtained in English
OR
they have a high school diploma or a minimum of two years of undergraduate education
(in any field) in English
b.
All other internationally educated applicants must have taken the IELTS (International English
Language Testing System) academic version within 24 months of application and achieved a
minimum score of 7.0 in each component.
14.
Enquiries about the status of your file should be emailed to the credentials department
credentials@cap.ab.ca.
15.
Refer to FAQ on CAP’s website.
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 3 of 12
1850 Sun Life Place
10123 - 99 Street NW
Edmonton, AB, T5J 3H1
Phone: (780) 424-5070
Toll Free: 1-800-659-0857 (in Alberta)
Fax: (780) 420-1241
credentials@cap.ab.ca
www.cap.ab.ca
Application for Evaluation of Academic Credentials
Ms. Mr. Dr. Mx. Female Male Other
Birthdate (month, day, year):
Full Legal Name (First Middle Last):
Previous Surname(s) (Used on any documents submitted):
Home Contact Information (will not be disclosed to the public)
Address: ________________________________________________________________________________________________
City/Town: _______________________________ Province/State: ___________________ Country: ____________________
Postal/Zip Code: ___________________________ Email: _________________________________________________________
Home Phone: ______________________________ Cell: ______________________________ Fax: ________________________
Have you previously applied to have your academic credentials evaluated? Yes
No
If yes, when: ___________________________________________________________________________________________
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 4 of 12
Personal information is collected, used and disclosed for the purpose of registration and for other
regulatory purposes in accordance with the Health Professions Act, Personal Information Protection
Act and the Privacy Policy of the College of Alberta Psychologists, which can be found on the CAP
website at www.cap.ab.ca. Please contact CAP’s Privacy Officer if you have any questions.
Payment Information
Amount $
Cheque/money order/bank draft (payable to College of Alberta Psychologists
)
Credit card (Amex, MasterCard, Visa)
Card number: Expiry Date:
Cardholder name:
Cardholder signature:
click to sign
signature
click to edit
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 5 of 12
1850 Sun Life Place
10123 - 99 Street NW
Edmonton, AB, T5J 3H1
Phone: (780) 424-5070
Toll Free: 1-800-659-0857 (in Alberta)
Fax: (780) 420-1241
credentials@cap.ab.ca
www.cap.ab.ca
Statutory Declaration
In the matter of my application to the College of Alberta Psychologists for evaluation of academic credentials:
I, of (city/town/village)
in the province/state/country of DO SOLEMNLY DECLARE that:
1.
I was born on (month day, year)
, at (place)
2.
I am the person referred to in the documents submitted in support of my application. All documents
submitted, including documents submitted at a later date and documents submitted either directly by me
or indirectly from an official source (e.g., official course syllabi sent from an academic institution), present
a true and accurate account of my credentials.
3.
The following is a true chronological summary of my post-secondary educational history (institutions
attended, state/province/country, dates of attendance, and degrees or diplomas earned):
4.
I acknowledge that the College of Alberta Psychologists may request additional information concerning my
application, and I hereby authorize the College to obtain any further information relevant to my application
from any person, including but not limited to persons or institutions referred to in my application documents.
I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same
force and effect as if made under oath or affirmation and by virtue of the
Canada Evidence Act
and the
Alberta Evidence Act
.
Declarant’s Signature:
Commissioner for Oaths, Justice of the Peace, or Notary Public
Signature, Seal, Stamp
click to sign
signature
click to edit
click to sign
signature
click to edit
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 6 of 12
1850 Sun Life Place
10123 - 99 Street NW
Edmonton, AB, T5J 3H1
Phone: (780) 424-5070
Toll Free: 1-800-659-0857 (in Alberta)
Fax: (780) 420-1241
credentials@cap.ab.ca
www.cap.ab.ca
Academic Credentials
Name:
A.
Accreditation
I obtained a graduate degree from:
A government-approved or government-authorized degree-granting institution of higher education in
Canada
A regionally accredited institution of higher education in the United States
A university in another country that has been recognized or authorized by an appropriate authority of
that jurisdiction
B.
Program Information
I graduated from (check all that apply):
A
non-thesis based graduate degree program
A thesis-based master’s/doctoral program
Title of Thesis (enclose thesis abstract):
C.
Language of Instruction
High School
Undergraduate Degree
Graduate Degree
English
English
English
Other
Other
Other
Please note that each course should only be listed once.
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 7 of 12
A. Core Areas -
Three semester credits required at the graduate level in each area
Ethics and Standards
Must be based on the Canadian Psychological Association (CPA) or American
Psychological Association (APA) Code of Ethics for Psychologists
Year
Academic
Institution
Course Number &
Name
Credits
Earned
Credits Approved
by Committee
Course/Credits
Re-assigned to:
Assessment and Evaluation
Year
Academic
Institution
Course Number &
Name
Credits
Earned
Credits Approved
by Committee
Course/Credits
Re-assigned to:
Totals
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 8 of 12
Core Areas Cont’d -
Three semester credits required at the graduate level in each area
Research Design and Methodology
Year
Academic
Institution
Course Number &
Name
Credits
Earned
Credits Approved
by Committee
Course/Credits
Re-assigned to:
Intervention and Consultation
Year
Academic
Institution
Course Number &
Name
Credits
Earned
Credits Approved
by Committee
Course/Credits
Re-assigned to:
Totals
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 9 of 12
B.
Substantive Content Areas
-
Three semester credits required at the graduate or
senior undergraduate level in each area
Biological Bases of Behaviour
Year
Academic
Institution
Course Number &
Name
Credits
Earned
Credits Approved
by Committee
Course/Credits
Re-assigned to:
Cognitive/Affective Bases of Behaviour
Year
Academic
Institution
Course Number &
Name
Credits
Earned
Credits Approved
by Committee
Course/Credits
Re-assigned to:
Totals
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 10 of 12
B. Substantive Content Areas Cont’d
- Three semester credits required at the
graduate or senior undergraduate level in each area
Social Bases of Behaviour
Year
Academic
Institution
Course Number &
Name
Credits
Earned
Credits Approved
by Committee
Course/Credits
Re-assigned to:
Psychology of the Individual
Year
Academic
Institution
Course Number &
Name
Credits
Earned
Credits Approved
by Committee
Course/Credits
Re-assigned to:
Totals
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 11 of 12
C. Other Psychology Coursework
- List all other psychology coursework completed (all
levels) not listed on the previous pages.
Year
Academic
Institution
Course Number &
Name
Credits
Earned
Credits Approved
by Committee
Course/Credits
Re-assigned to:
Totals
Print additional pages if required
Application for Evaluation of Academic Credentials Pathways 1 and 2 / April 2021
Page 12 of 12
Approved
Approved at doctoral level (if applicable)
Conditionally Approved
Requires further documentation
Denied
Deficient
Number of graduate credits deficient
Total # of psychology credits deficient
Approved
Number of graduate credits approved
Total # of psychology credits approved
Summary
(for office use only - do not detach from application)
Degree
Total semester credits
required
Graduate semester
credits required
Remaining semester
credits can be graduate
and/or undergraduate
Thesis-based degree
60
30
30
Non-thesis based degree
72
36
36
Comments:
Reviewed by: Date:
Reviewed by: Date:
Reviewed by: Date: