Fillable Application for Full Registration

Fill Online, Printable, Fillable, Blank Application for Full Registration Form

Use Fill to complete blank online OTHERS (CANADA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Application for Full Registration

On average this form takes 27 minutes to complete

The Application for Full Registration form is 7 pages long and contains:

  • 2 signatures
  • 12 check-boxes
  • 96 other fields

Country of origin: CANADA
File type: PDF

BROWSE OTHERS (CANADA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
1
Application for Full Registration
(Application to Become a Registered Social Worker (RSW))
Applicants must read through this entire package before starting to complete it. Applications cannot be
considered until the requirements of each part are complete and have been received by the College.
Valid Email: Once your application has been received by the College, it generally takes 8-10 weeks
for the College to process your application. After processing your application, the College will provide
an update on your application status via email. Please provide an up-to-date email address in Section
1 on page 3 and make sure to check your inbox as well as spam/junk folder frequently. If you see the
College’s email in your spam/junk folder, please mark it as a safe sender.
Application Requirements:
For instructions and details regarding each part of the application requirements, please see Index A
on page 8 of this application form.
1. Application form
2. Consent to a Criminal Record Check form
3. Copy of two pieces of identification
4. Original copy of Police Information Check (or other applicable criminal record check(s))
a. This is a requirement separate from and in addition to completing the 'Consent to a Criminal
Record Check form' listed as item 2 above.
5. Resume
6. Official transcript
7. Two reference forms
8. Verification of Registration/Licensure form (if required)
Licensure Examination:
Upon receiving and approving a completed application, the College will authorize the applicant to
write a competency-based licensure exam. The exam level will be determined according to the
applicant’s academic credential and will be either the ASWB Bachelor level or Master level
examination. Successful completion of the exam is a requirement for registration with the College.
Applicants licensed in another Canadian jurisdiction are encouraged to contact the College.
2
Application for Full Registration
(Application to Become a Registered Social Worker (RSW))
Section 1 – Personal Information
Legal Last
Name:
Legal First
Name:
Middle
Name:
Date of
Birth:
Sex:
Male
Female
Preferred
First Name:
(if different from
legal first name)
Other Names Used or Have Used: (e.g. maiden name, birth name, or previous married name)
Last
Name:
First:
Middle:
Last
Name:
First:
Middle:
Mailing Address:
City:
Province:
Country:
Postal
Code:
Phone #:
Personal
Email Address:
Section 2 – Employment Information
If you are employed in a social work related position, please fill out this section. If you are not yet employed,
you have to provide this information prior to beginning work. If you are employed in more than one location,
whether part-time, full-time or in private practice, please include an additional piece of paper with all the
details listed below for each location of employment.
Name of Employer:
Worksite:
Business
Address:
City:
Province:
Country:
Postal
Code:
Business Phone:
Local:
Work email
address:
3
Section 3 – Education and Experience
Highest Social
Work Degree:
Year Obtained:
If you do not have a social work degree, please contact the College before proceeding.
Section 4 – Professional Affiliations
Regulatory
Body: Registration Number:
Regulatory
Body: Registration Number:
If you are currently or ever have been registered with any other regulatory body in any profession,
please complete the appropriate ‘Verification of Registration' form which can be found on our website.
Section 5 – Professional Conduct Disclosure
a. Have you ever been the subject of a finding of professional misconduct or
incompetence?
YES NO
b. Are you currently the subject of a proceeding in relation to professional misconduct, or
incompetence?
YES NO
If you have answered yes to either of the questions above, please attach a separate sheet of paper with
details of the situation and findings.
Section 6 – Consent to Disclose
The College offers Registrants the choice to have their business address and telephone number listed
on the public registry. If you would like your business address and telephone number published please
provide consent and details below.
If my application is approved, I consent to the publication of my business address and telephone
number to my profile on the College online registry 
YES
NO
Business Address: ___________________________________________________________________________________
Business Phone: ____________________________________
Institution:
Do you have at least 700 hours of social work experience from
practicums and/or other social work related positions?
(If you have less than 700 hours, you will be required to complete an
upgrading program set by the Registration Committee.)
YES NO
4
Section 7 – Application Statement
Canada, Province of British Columbia, in the matter of an application for registration with the British Columbia
College of Social Workers
I,
of
(Name)
(City)
do solemnly declare that:
I have not been convicted in Canada or elsewhere of any offence that, if committed by a person registered
under the Social Workers Act, would constitute unprofessional conduct or conduct unbecoming a person
registered under these bylaws except as follows:
My past conduct does not demonstrate any pattern of incompetence or untrustworthiness which would make
registration contrary to the public interest.
I am a person of good character.
My entitlement to practise social work has not been limited, restricted or subject to conditions in any
jurisdiction at any time except as follows:
At the present time, no investigation, review or proceeding is taking place in any jurisdiction which could
result in the suspension or cancellation of my authorization to practise social work in that jurisdiction except
as follows:
I have read the Social Workers Act of British Columbia, the Bylaws of the British Columbia College of Social
Workers made pursuant to that Act.
I will practise at all times in compliance with the Social Workers Act of British Columbia, and the bylaws of
the British Columbia College of Social Workers made pursuant to that Act.
And 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.
The personal information requested on this form is collected under the authority of and will be used for the purpose of
administering the registration process under the Social Workers Act. The collection, use and disclosure of personal
information are subject to the provisions of the Freedom of Information and Protections of Privacy Act. If you have any
questions about the collection, use or disclosure of this information, please contact the Registrar of the BC College of Social
Workers at 604-737-4916.
Applicant’s Signature:
Date:
click to sign
signature
click to edit
5
Application Fee Payment Form
Card Number:
Expiry Date:
M
M
Y
Y
CVD/CVV: __________ (three-digit number on the back of credit card)
Name Printed on Card:
Authorized Signature:
Please complete and submit with your application
Credit Card Holder Contact Information
Last Name:
First Name:
Mailing Address:
City:
Province:
Country:
Postal Code:
Phone #:
Email Address:
Fee Information
A non-refundable fee of $132.00 is required to process the application
Fees are payable by Visa, MasterCard, money order or cheque
Cheques are payable to the BC College of Social Workers
There is a $25 charge for any cheque returned insufficient funds
If your application is approved, you will receive an email containing an application
approval letter and an invoice for the registration fee, which is separate from the
application fee. Initial registration fee is prorated based on the month of approval.
Amount:
$132.00
Payment:
Mastercard
Visa
Cheque Enclosed
#
click to sign
signature
click to edit
PART 1 – APPLICANT/REGISTRANT INFORMATION
Last Name: Full Middle:
Birth Date:
Full First:
Sex:
Male
Female Birth Place:
(yyyy/mm/dd) (City, Province/State, Country)
OTHER NAMES USED OR HAVE USED: (e.g., maiden name, birth name, or previous married name)
Surname: First: Middle:
Surname: First: Middle:
Surname: First: Middle:
Mailing Address:
City: Country: Postal Code:
Contact Phone : ( )
Province:
Canadian Driver Licence #
:
PART 2 – ORGANIZATION INFORMATION
Organization Name: BRITISH COLUMBIA COLLEGE OF SOCIAL WORKERS
Governing Body
ID Number (provided by the Criminal Records Review Office): 004
Page 1 of 2
PSSG08-000— 01/2008
Schedule B
IMPORTANT: Please read information and instructions on Page 2.
Criminal Records Review Program
Consent to a
CRIMINAL RECORD CHECK
Ministry of Public Safety
and Solicitor General
Policing and Community Safety Branch
Security Programs
Criminal Records Review Program
Submit Form to:
info@bccsw.ca OR
BCCSW
1420 1200 West 73 Avenue
Vancouver, BC V6P 6G5
CONSENT FOR RELEASE OF INFORMATION AND ACKNOWLEDGEMENTS:
p I have read and understand the Consent for Release of Information and Acknowledgements on Page 2. I hereby
consent to these terms as indicated by my signature below.
p I hereby authorize my organization as indicated in Part 2 - Organization Information to conduct criminal record checks on an ongoing basis,
every five years. I understand that I may contact my organization to withdraw this consent for future criminal record checks.
Applicant Signature
Must be physical signature (digital not accepted)
Date Signed
Parent or Guardian Signature for
Applicant Under 19 Years of Age
x
x
Consent to a Criminal Record Check (Schedule B)
The information requested on this form is collected under the authority of the section 4(1) of the Criminal Records Review Act and section 26(c) of the
Freedom of Information and Protection of Privacy Act (FOIPPA). The information provided will be used to fulfill the requirements of the Criminal Records
Review Act for the release of criminal records information and is in compliance with the FOIPPA. If you have questions about the collection of your
personal information, please contact the Policy Analyst, Criminal Records Review Program, PO Box 9217 Stn Prov Govt, Victoria, BC V8W 9J1 or by
phone at 1-855-587-0185.
Page 2 of 2
INFORMATION and INSTRUCTIONS
Page 1 is set up with 'form fields' so you may complete it at your computer then print the number of copies
required. You may also complete the form by hand, but please print clearly using dark ink. Processing delays
will result if the form submitted is incomplete, incorrect or if information cannot be read clearly. For more
information, contact the British Columbia College of Social Workers at (604) 737-4916.
Schedule B: use if the individual is a) applying for membership or is a registered member of a B.C. governing body
listed in Schedule 2 of the Criminal Records Review Act, or b) is a registered student in a post-secondary program with
a practicum component involving work with children and/or vulnerable adults. The requesting organization retains the
consent form.
CHECKLIST for Applicant/Registrant
I have completed all the applicable sections of the form truthfully, clearly and legibly, and signed and dated it.
I have read and understand the Consent for Release of Information and Acknowledgements and information
regarding the Freedom of Information and Privacy Act (FOIPPA) – (outlined below).
I have signed and dated the Consent to a Criminal Record Check form.
I understand the British Columbia College of Social Workers will retain proof of the original form and will submit
information from this form to the Criminal Records Review Program for the purposes of the Criminal Records
Review Act.
CONSENT FOR RELEASE OF INFORMATION AND ACKNOWLEDGEMENTS
PURSUANT TO THE B.C. CRIMINAL RECORDS REVIEW ACT
I hereby consent to a check for records of criminal charges and convictions to determine whether I have a
conviction or outstanding charge for any relevant or specified offence(s) under the Criminal Records Review
Act;
o I hereby consent to a check of all available law enforcement systems, including any local police
records.
o I hereby consent to a vulnerable sector search to check if I have been convicted of and been
granted a pardon for any sexual offences of the Criminal Records Act.
o I understand a criminal record check under the Criminal Records Review Act is required at least
once every five years.
o Go to the RCMP website for additional details on vulnerable sector checks: http://www.rcmp-
grc.gc.ca/en/faqs-about-vulnerable-sector-checks
I hereby authorize the release to the Deputy Registrar any documents in the custody of the police, the court
and crown counsel relating to an outstanding charge or conviction of any relevant offence as defined under
the Criminal Records Review Act.
Where the results of this check indicate that a criminal record or outstanding charge for a relevant offence
may exist, I agree to provide my fingerprints to verify any such criminal record.
The Deputy Registrar will notify me and my organization that I have an outstanding charge or conviction for
any relevant offence(s) and the matter has been referred to the Deputy Registrar;
The Deputy Registrar will determine whether or not I present a risk to physical or sexual abuse to children;
The Deputy Registrar's determination will be disclosed to my organization and it will include consideration of
any relevant offence for which I have received a pardon;
If I am charged with or convicted of a relevant offence at any time subsequent to the criminal record check
authorized herein, I further agree to report the charge or conviction to my organization and provide my
organization, in a timely manner, with a new signed Consent to a Criminal Record Check form.
8
Index A
1. Application Form: All pages of the attached Application form should be completed and sent to the College,
including the $132 Application fee payment. This form can be sent to the College by email, fax, or mail.
2. Consent to a Criminal Record Check form: You can find this form attached to this Application form. This is a
requirement pursuant to the BC Criminal Records Review Act. Do not take this form to a police detachment.
Simply complete this form and send it to the College by email, fax, or mail.
3. Identification: A high quality copy of two (2) pieces of identification. One must be government issued photo
identification. These copies can be sent to the College by email, or mail. For a list of acceptable ID, click here.
Applicants born outside Canada must provide proof of Canadian citizenship, permanent residency or work permit
with a copy of both sides of their Canadian immigration status once these documents are available.
4. Police Information Check (this is a requirement separate from and in addition to completing the 'Consent to a
Criminal Record Check' form listed as item 2 above): Applicants are required to submit a national or federal
criminal record check from their country of residence. The original copy of the result of the check must be mailed
to the College by the applicant if the issuing agency will not send it directly to the College.
a. If your country of residence is Canada, this requirement can be fulfilled by visiting your local police
detachment and requesting a Police Information Check including the vulnerable sector.
b. If your country of residence is the USA, you are required to submit an FBI Identity History Summary
Check.
c. Criminal record checks are required from any country in which an applicant was a resident or worked as
an adult. If citizenship or permanent residency in Canada has been granted and the applicant has not
resided outside Canada since the date of issue, the College may accept proof of a Permanent Resident
Card or Canadian Citizenship or Canadian work permit information in lieu of international criminal record
checks.
d. A criminal record does not automatically disqualify an applicant from registration; however, it is necessary
to provide details of the incident that gave rise to the criminal record.
5. Resume: An up-to-date resume with complete work history pertaining to social services. Applicants may be
required to provide additional information. This can be sent to the College by email, fax, or mail.
6. Official Transcript: An official transcript of your highest social work degree must be mailed directly to the College
by the awarding institution.
a. If you have completed all the requirements of your degree but are awaiting conferral, please request an
official ‘Degree Completion Letter’ to be sent directly to the College from the educational institution by mail
or email (info@bccsw.ca); degrees are not listed on transcripts until after convocation.
i. Applicants must still arrange for an official transcript to be mailed directly to the College after their
degree has been conferred by the awarding institution.
b. Applicants educated outside Canada and the USA must arrange to have a basic report from the
International Credential Evaluation Service (ICES) sent directly to the BCCSW. Find their information at
www.bcit.ca/ices
c. Applicants who do not have a social work degree should refer to the College’s requirements for individuals
without a social work degree here.
7. Reference Forms: Two (2) letters of reference on the forms provided sent directly to the College by the referees
(refer to the website for correct form).
a. Referees must have known the applicant for over one year and not be a relative.
b. Reference forms can be sent to the College through email, fax, or mail.
8. Verification of Registration/Licensure form: Applicants, who are currently or have been in the past registered
with another regulatory body, are required to have this form submitted by each regulatory body. There are
separate forms for social work regulators and non-social work regulators, which can be found on the
'Application Forms' page of our website. Please ensure that you are using the appropriate form. This form must be
mailed back to the College from the other body.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Application for Full Registration

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 7 May 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document