CRCC


CONTINUING EDUCATION PRE-APPROVAL MANUAL

FOR

ORGANIZATIONS PROVIDING CONTINUING EDUCATION

TO

CERTIFIED REHABILITATION COUNSELORS (CRCs)
CANADIAN CERTIFIED REHABILITATION COUNSELORS (CCRCs), AND
CRCs HOLDING A MASTER ADDICTIONS COUNSELOR (MAC) OR CLINICAL SUPERVISOR (CS) ADJUNCT DESIGNATION


EFFECTIVE FOR PROGRAMS OFFERED AND COMPLETED
IN CALENDAR YEAR 2007


Commission on Rehabilitation Counselor Certification
Department 4427
Carol Stream, IL 60122-4427
(847) 944-1325
http://www.crccertification.com

Accredited by the National Commission for Certifying Agencies

Introduction

The Commission on Rehabilitation Counselor Certification (CRCC) is committed to developing and maintaining exemplary standards of practice for professionals who practice rehabilitation counseling. The Commission strives to elevate the quality of services provided to consumers so each and every professional takes pride in his or her chosen field, and so each and every consumer receives services that enhance his or her vocational opportunities.

Hence, CRCC believes that individuals certified as rehabilitation counselors (CRCs, CCRCs, CRC-MACs, CRC-CSs, and CRC-MAC-CSs) should continue to expand their skills in order to enhance the quality of the services they provide. Therefore, CRCC’s certification renewal requirements are designed to encourage rehabilitation counselors to continue their professional education through the attainment of continuing education in order to help them serve their clients more effectively.

While certified individuals have the option to achieve certification renewal through passing the examination, continuing education is much more frequently used as a method of certification renewal. Those who choose to renew through continuing education are required to achieve 100 clock hours within the five-year period of certification, 10 of which must be in ethics.

In order to maintain a high quality of continuing education opportunities, CRCC has a pre-approval process for continuing education programs/activities. Organizations that sponsor continuing education and training are encouraged to seek pre-approval of their programs/activities, which signifies to all certified individuals that the programs/activities are appropriate to use toward meeting the requirements of their certification renewal program.

This Continuing Education Pre-Approval Manual is designed to describe the requirements and procedures involved for those organizations that wish to seek pre-approval of their programs/activities.

Approval Categories

Standard Approval Category
All Organizations Seeking Pre-Approval of Continuing Education Opportunities – Any organization that does not otherwise qualify or that does qualify but does not wish to take part in any of the alternative approval processes. Organizations are subject to a $50 fee per program/activity. Individual applications and payment of the fee must be made for each program/activity.

Alternative Approval Categories
Employers Providing In-service Training – Organizations are limited to employers that provide in-service training solely to their employees and at no charge to their employees. Organizations are subject to a quarterly fee of $50.00 and must submit applications for each training session directly to CRCC in order that CRCC may issue approval numbers. Quarterly applications must be made and must include the programs for that quarter.

Appointing Organizations -– Organizations are limited to appointing organizations of CRCC. Organizations are granted full approval authority at a cost of $200 per calendar year for programs they offer. Annual applications and reports must be filed. Organizations cannot issue approval to any ther vendors offering continuing education.

Education, Training, and Research Programs -– Organizations limited to CORE-Accredited Rehabilitation Counselor Education Programs, State Agency Divisions for Vocational Rehabilitation/State Agencies for the Blind and Visually Impaired, the Federal Department of Veterans Affairs, Research and Training Programs, and Regional Continuing Education Programs. Organizations are granted full approval authority at no fee for programs they offer. Annual applications and reports must be filed. Organizations cannot issue approval to any other vendors offering continuing education.
Approval Requirements

Regardless of the category under which an organization applies for pre-approval, and regardless of whether CRCC grants the approval or whether an organization is granted that authority, the following equirements must be met prior to the granting of approval and issuing of an approval number.
•
The program must be no less than one clock hour in duration. A clock hour is defined as 60 minutes of instruction time and excludes coffee breaks, social hours, meals, etc.
•
The focus of the program must be to increase the participant’s knowledge of or skill in the practice of rehabilitation counseling. To be approved, a program must clearly meet one of the domain focus areas for continuing education.
•
The purpose of the program must be clearly defined in terms of expected outcomes/learning objectives.
•
The program must include an evaluation component completed by the participants. This is an evaluation of the program’s value –- not an assessment of the participant’s learning skills.
•
It is CRCC’s philosophical belief that all programs must be held in accessible, barrier-free locations so that no one with a disability is excluded from participation. CRCC strongly encourages all programs to comply with relevant federal, state/provincial, and local laws related to serving individuals with disabilities.

Approval Process

CRCC reserves the right to monitor the programs and activities for which it has granted approval and to withdraw its approval from any program or activity that is offered or presented in a manner that is inconsistent with approval requirements. The approval process is as follows:
•
The application consistent with the approval category under which an organization is seeking approval must be completed in full and the requested documentation must be attached along with the appropriate fee. Applications are located in the back of this manual, which is also available at www.crccertification.com. Any application submitted that is not accompanied by the appropriate fee and/or required materials will be returned.
•
Approval must be obtained/granted for each program/activity. For example, an in-service training program that is two hours in length and given on one day is considered one program/activity. Likewise, a conference consisting of a variety of sessions given over a period of three days is also considered one program/activity. Any sessions meeting the ethics domain focus area must be highlighted separately and a separate approval number sought/granted.
•
Applications under the Standard Approval Category must be postmarked 30 days prior to the initiation date of the program/activity in order to guarantee CRCC’s review and approval before the program date. Applications received with less than a 30-day lead-time will be reviewed on a first come, first serve basis and will require a $50.00 late application fee, but it cannot be guaranteed that approval will be granted prior to the program date.
•
Applications under the Alternative Approval Categories must be submitted by the timeframe indicated on the application. Applications received after the timeframe will be subject to the late application processing fee of $50.00.
•
Approval for any continuing education program/activity is valid for the timeframe indicated on the application, provided that no substantive changes are made to the content or format of the program/activity.
•
Programs/activities for which approval is granted will be considered pre-approved for individuals holding a CRC, CCRC, CRC-MAC, CRC-CS, or CRC-CS-MAC certification.

Issuing the Approval Number

Organizations seeking approval under the Standard Approval Category or employers seeking approval of their in-service training sessions will be provided with an approval number(s) and a sample verification of completion form. The verification of completion form distributed to each participant must contain the approval number(s) as well as all other descriptors located in the sample verification of completion form. The verification of completion form is to be distributed only at the close of the program/activity. The assigned approval number(s) is not to be printed on any general istribution handouts or mailing information.

Organizations applying under Alternative Approval Categories that allow them to issue approval numbers for their activities will be provided with instructions on how to issue accurate approval numbers and will be provided with a sample verification of completion form. The individual granting approval must be a CRC or CCRC. The verification of completion form distributed to each participant must contain the approval number(s) as well as all other descriptors located in the sample verification of completion form. The verification of completion form is to be distributed only at the close of the program/activity. The assigned approval number(s) is not to be printed on any general distribution handouts or mailing information.

Ethics Definition

In order to be classified in the Ethics focus area, the content of the program must convey specific behavior that is related back to, preferably, the CRCC Code of Professional Ethics for Rehabilitation Counselors or, alternatively, the ACA Code of Ethics and Standards of Practice. Appropriate subject atter must relate to rehabilitation counseling and must include one of the following:
• the counseling relationship • teaching, training, and supervision
• confidentiality • research and publication
• professional responsibility • electronic communication/emerging applications
• relationships with other professionals • business practices
• evaluation, assessment, and interpretation • resolving ethical issues

Criteria for CE Offered Solely Through Written Means

Continuing education offered solely through written means (e.g., home study courses) is subject to application of the following criteria where the course/article must meet the minimum number of words/questions in order to obtain the stated number of hours.
Number of Words Number of Multiple-Choice Questions Number of Hours Approved
Up to 10,000 10 2
10,000--20,000 15 4
20,000--30,000 20 6
Every 10,000 Thereafter 05 Additional Questions 2 Additional Hours

Articles that appear in a peer-reviewed journal where the article is read and a minimum of five uestions are answered and submitted for credit are awarded a flat 3 clock hours.

If the organization requesting approval is dissatisfied with the number of hours awarded, provided that the number of hours awarded is a minimum of 15 hours, the organization may request a review by the Standards and Credentials Committee. The burden to prove why additional hours should be awarded remains with the organization requesting approval

Program Review Fee

Review fees are categorized according to the Approval Category under which an organization applies nd under which they are qualified. See the following chart to identify the applicable fee.
Category* Fee**
Standard Approval Category $50.00 Per Program/Activity
Employers Providing In-Service Training $50.00 Per Quarter
Appointing Organizations $200.00 Per Calendar Year
Education, Training, and Research Programs No Charge

** See approval categories on page one.
** All fees are non-refundable. An additional processing fee of $50.00 applies to those organizations requesting priority processing. Priority processing is considered to be requests for processing within two weeks of receipt. Likewise, a late application processing fee of $50.00 applies to those organizations requesting processing of applications subsequent to the deadline stated on the application.

Domain Focus Areas for Continuing Education

The following areas constitute the domain focus areas that are appropriate for continuing education for rehabilitation counselors. Headings in bold denote the domain focus areas while those indented below further explain the areas related to the domain focus area.

Ethical Standards or Decision Making Models for Rehabilitation Counselors

Vocational Consultation and Employer Services
Employer practices that affect the employment or return to work of individuals with disabilities
Ergonomics
Job modification and restructuring techniques
Job analysis
Consultation services available from rehabilitation counselors for employers
Methods and techniques used to conduct labor market surveys
Work conditioning or work hardening resources and strategies
Accommodation and rehabilitation engineering services
Marketing strategies and techniques for rehabilitation services
The workplace culture and environment

Job Development and Placement Services
Employer development and job placement
Client job seeking skills development
Client job retention skills
Job placement strategies
Job and employer development
Follow-up/post employment services
Occupational and labor market information
Vocational implications of functional limitations associated with disabilities

Career Counseling and Assessment Techniques
Tests and evaluation techniques available for assessing client’s needs
Computer-based counseling tools in rehabilitation counseling
Computer-based job-matching systems
Interpretation of assessment results for rehabilitation planning purposes
Internet resources for rehabilitation counseling
Assistive technology
Theories of career development and work adjustment
Transferable skills analysis

Mental Health Counseling
Mental health and psychiatric disability concepts
Rehabilitation techniques for individuals with psychological disabilities
Treatment planning for clinical problems (e.g., depression and anxiety)
Substance abuse and treatment
Human sexuality and disability issues
Wellness and illness prevention concepts and strategies

Group and Family Counseling
Family counseling theories
Family counseling practices and interventions
Group counseling practices and interventions
Group counseling theories

Individual Counseling
Individual counseling theories
Individual counseling practices and interventions
Behavior and personality theory
Human growth and development

Psychosocial and Cultural Issues in Counseling
The psychosocial and cultural impact of disability on the family
The psychosocial and cultural impact of disability on the individual
Multicultural counseling issues
Gender issues
Societal issues, trends, and developments as they relate to rehabilitation
Techniques for working with individuals with limited English proficiency

Foundations and Professional Issues
The design of research projects, program evaluation and needs assessment approaches
Basic research methods
The history of rehabilitation
The philosophical foundations of rehabilitation
The evaluation procedures for assessing the effectiveness of rehabilitation services and outcomes
Theories and techniques of clinical supervision
Advocacy processes needed to address institutional and social barriers that impede access, equity, and success for clients
The legislation or laws affecting individuals with disabilities

Rehabilitation Services and Resources
Supported employment strategies and services
School to work transition for students with disabilities
The services available for a variety of rehabilitation populations, including persons with multiple disabilities
Planning the provision of independent living services with clients
Financial resources for rehabilitation services
Community resources and services for rehabilitation planning
Social Security programs, benefits and disincentives
The organizational structure of the public vocational rehabilitation service delivery system
Rehabilitation services in diverse settings
The organizational structure of the not-for-profit service delivery systems

Case and Caseload Management
Case management process and tools
Case recording and documentation
Principles of caseload management
Professional roles, functions, and relationships with other human service providers
Clinical problem-solving and critical-thinking skills
Negotiation and conflict resolution strategies
The case management process, including case finding, service coordination, referral to and utilization of other disciplines, and client advocacy
Techniques for working effectively in teams and across disciplines

Healthcare and Disability Systems
Managed care concepts
Health care delivery systems
Employer-based disability prevention and management strategies
Workers’ compensation laws and practices
Techniques for evaluating earnings capacity and loss
Expert testimony
Life care planning
The organizational structure of the private-for-profit vocational rehabilitation systems
Healthcare benefits
Appropriate medical intervention resources

Medical, Functional and Environmental Implications of Disabilities
Environmental barriers for individuals with disabilities
The physical/functional capacities of individuals with disabilities
Medical aspects and implications of various disabilities
Rehabilitation terminology and concepts
Medical terminology
Attitudinal barriers for individuals with disabilities

Addictions Counseling
Foundations of addictions counseling
Addictions diagnosis/assessment
Clinical addictions counseling
Addictions counseling and special populations
Co-existing disabilities where an addiction is one of the disorders
Group counseling with persons who have addictions disorders
Family assessment, counseling, and other rehabilitation services
Vocational rehabilitation services
Case management
Addictions prevention, education, and consultation
Professional responsibility
Research
Administration and supervision of drug rehabilitation programs

Clinical Supervision
Supervision process
Roles and functions of clinical supervision
Models of clinical supervision
Counselor development
Methods and techniques of clinical supervision
Supervisory relationship issues
Diversity issues in clinical supervision
Group supervision
Legal and ethics issues in clinical supervision
Evaluation of supervisory competence and the supervision process

RECOMMENDED CITATION

Commission on Rehabilitation Counselor Certification. (2007). Continuing Education Pre-Approval Manual For
Organizations Providing Continuing Education To Certified Rehabilitation Counselors (CRCCs), Canadian Certified
Rehabilitation Counselors (CCRCs), and CRCs Holding A Master Addictions Counselor (MAC) Or Clinical
Supervisor (CS) Adjunct Designation.
Retrieved [date] from,http://www.crccertification.com/pages/20ce_provider.html
CRCC

All priority mail (requires an additional
$50 processing fee) with application fee
must be mailed to:
Commission on
Rehabilitation Counselor Certification
300 N. Martingale Road, Suite 460
Schaumburg, IL 60173
(847) 944-1325
To avoid delay in processing,
all other applications
(with standard fee) must be mailed to:
Commission on
Rehabilitation Counselor Certification
Department 4427
Carol Stream, IL 60122-4427
(847) 944-1325

STANDARD APPROVAL CATEGORY APPLICATION

Organizations seeking pre-approval of continuing education opportunities that do not otherwise qualify for, or that do qualify for but do not wish to take part in any of the alternative approval processes, must complete this two-page application for each program/activity.
Applications must be submitted 30 days preceding the date of the program/activity. Indicate whether you are requesting priority or submitting a late application processing fee. (See page 3 for additional information.)
Priority Processing Requested. Requires payment of additional processing fee of $50.00.
Late Application Processing Requested. Requires payment of additional processing fee of
$50.00.
Organization Information

______________________________________________
Organization Offering Program/Activity

______________________
Sponsor Code (if known)

______________________________________________
Address
______________________
Telephone Number

______________________________________________
City/State or Province/Zip or Postal Code
______________________
Facsimile Number

______________________________________________
Program Contact Person
______________________
Organization Website
Program/Activity Information

______________________________________________
Program/Activity Title

______________________
Location

______________________________________________
Actual Number of Clock Hours of Training (excluding breaks)
______________________
Date(s) of Training

Indicate Cost to Participants: _____________________________________________________

Length of Training in Days (Circle One): __1__ 2__ 3__ 4__ 5__ 6__ 7_ _8

Number of Participants Expected (Circle One): __1-25 __26-50 __51-100 __101-150 __150+

Type of Instruction:
1-Multi-day Conference
 2-Seminar/Workshop
3-Home Study
 4-College/University Course
 5-Internet
If Solely in Written Format:
Indicate Number of Words ________ Indicate Number of Questions _____
Documentation to be Attached
• One copy of promotional material such as direct mail flyer or marketing brochure
• An outline or agenda, if not contained within the promotional material, to include a breakdown of clock hours.
• A copy of the evaluation form to be given to participants.
• A check made payable to CRCC in the amount of $50.00 unless priority or late application processing is required, in which case the amount may be up to $150.00.
Relation to Domain Focus Areas

The program/activity must apply to one of the following domain focus areas. A full listing of the areas related to each domain focus area can be found on pages 4-6. Please check the domain focus area that applies to the program/activity for which you are seeking approval.
Ethical Standards or Decision Making Models for Rehabilitation Counselors (13)
Vocational Consultation and Employer Services (01)
Job Development and Placement Services (02)
Career Counseling and Assessment Techniques (03)
Mental Health Counseling (05)
Individual Counseling (06)
Psychosocial and Cultural Issues in Counseling (07)
Foundations and Professional Issues (08)
Rehabilitation Services and Resources (09)
Case and Caseload Management (10)
Healthcare and Disability Systems (11)
Medical, Functional and Environmental Implications of Disabilities (12)
Addictions Counseling (14)
Clinical Supervision (15)
Payment Information

CHECKS: Checks must be made payable to CRCC and returned with a completed application and required documentation. A service fee of $35.00 will be assessed for all checks returned for insufficient funds or for charges made to closed accounts. CRCC’s tax identification number is 36-3733179.

CREDIT CARD PAYMENT: All charges for CRCC are processed through the Foundation for Rehabilitation Education and Research. The Foundation will appear on your credit card payment. Complete this section if you wish to charge the fees due to your VISA or MasterCard.

Charge U.S. $ ____________ to my ____ VISA ____ MasterCard
Card #__________________________________ Expiration Date____________
Signature________________________________ Date____________________
Statement of Understanding

I hereby certify that I have read, understand, and agree to abide by the requirements as stated within the Continuing Education Pre-Approval Manual. Furthermore, I certify that I have completed the application and attached the required documentation. I understand that no program/activity will be reviewed unless accompanied by the required documentation, to include the appropriate non-refundable processing fee.

I understand that CRCC reserves the right to monitor programs/activities for which it has granted continuing education approval and to withdraw such approval from any program/activity that is offered or presented in any manner that is inconsistent with the approval requirements. I also understand that any approval granted for this program/activity is valid for only one calendar year (January 1 through December 31). If the program/activity is changed in any way during that year, I agree to seek approval from CRCC.
_________________________________________
Authorized Signature		 __________________________
Date
_________________________________________
Printed Name		 __________________________
Title

Rev. 11/06
CRCC

To avoid delay in processing, applications being returned with payment must be sent to:
Commission on
Rehabilitation Counselor
Certification
Department 4427
Carol Stream, IL 60122-4427
(847) 944-1325

All other correspondence should be
mailed to:
Commission on
Rehabilitation Counselor
Certification
300 N. Martingale Road, Suite 460
Schaumburg, IL 60173
(847) 944-1325

APPLICATION FOR EMPLOYERS PROVIDING IN-SERVICE TRAINING

Employers that provide in-service training solely to their employees and at no charge to their employees must complete this two-page application and submit payment in the amount of $50.00 for each quarter (i.e., January-March, April-June, July-September, or October-December).
Check the quarter and year for which approval is being sought. A separate application is required for each quarter.
Quarter 1st Quarter
__ (Jan--Mar)		 2nd Quarter
__ (Apr--Jun)		 3rd Quarter
__ (Jul--Sep)		 4th Quarter
__ (Oct--Dec)
Year 2007 Other (specify)_________________
Applications must be submitted 30 days preceding the quarter for which approval authority is being sought. A late application processing fee of $50.00 will be applied for applications submitted less than 30 days before the quarter. Indicate if you are submitting a late application processing fee by checking the box below.

 Late Application Processing Requested. Requires payment of a processing fee of $50.00.
Organization Information
_________________________________________
Organization Offering Programs/Activities
__________________________
Sponsor
_________________________________________
Address		 __________________________
Telephone Number
_________________________________________
City/State or Province/Zip or Postal Code		 __________________________
Facsimile Number
_________________________________________
Program Contact Person		 __________________________
Organization Website
Documentation to be Attached
1.
If solely in written format, include a copy of the course and indicate number of words/questions.
2. An outline or agenda of each program/activity to include a breakdown of clock hours.
3.
In addition to items one or two above, as applicable, a list of the programs/activities to be offered during the quarter for which approval is being sought. The list must include:
• The program/activity title.
• The location where the program/activity occurred.
• The actual number of clock hours of training (excluding breaks).
• The date(s) of training.
• The length of training in days.
• The number of participants expected.
• The type of instruction (Multi-day Conference; Seminar/Workshop; Home Study/Internet).
• The domain focus area applicable to the program/training based on the following options:
Ethical Standards or Decision Making Models for Rehabilitation Counselors (13)
Vocational Consultation and Employer Services (01)
Job Development and Placement Services (02)
Career Counseling and Assessment Techniques (03)
Mental Health Counseling (05)
Individual Counseling (06)
Psychosocial and Cultural Issues in Counseling (07)
Foundations and Professional Issues (08)
Rehabilitation Services and Resources (09)
Case and Caseload Management (10)
Healthcare and Disability Systems (11)
Medical, Functional and Environmental Implications of Disabilities (12)
Addictions Counseling (14)
Clinical Supervision (15)
Payment Information

CHECKS: Checks must be made payable to CRCC and returned with a completed application and required documentation. A service fee of $35.00 will be assessed for all checks returned for insufficient funds or for charges made to closed accounts. CRCC’s tax identification number is 36-3733179.

CREDIT CARD PAYMENT: All charges for CRCC are processed through the Foundation for Rehabilitation Education and Research. The Foundation will appear on your credit card payment. Complete this section if you wish to charge the fees due to your VISA or MasterCard.

Charge U.S. $ ____________ to my ____ VISA ____ MasterCard
Card #__________________________________ Expiration Date____________
Signature________________________________ Date____________________
Statement of Understanding

I hereby certify that I have read, understand, and agree to abide by the requirements as stated within the Continuing Education Pre-Approval Manual. Furthermore, I certify that I have completed the application and attached the required documentation. I understand that no program/activity will be reviewed unless accompanied by the required documentation, to include the appropriate non-refundable processing fee.

I also certify that the program/activity is an in-service training that is being offered solely to employees of the organization seeking approval and is at no cost to the employees.

I understand that CRCC reserves the right to monitor programs/activities for which it has granted continuing education approval and to withdraw such approval from any program/activity that is offered or presented in any manner that is inconsistent with the approval requirements. I also understand that any approval granted for this program/activity is valid for only one calendar year (January 1 through December 31). If the program/activity is changed in any way during that year, I agree to seek approval from CRCC.
_________________________________________
Authorized Signature		 __________________________
Date
_________________________________________
Printed Name		 __________________________
Title

Rev. 05/06

CRCC

To avoid delay in processing, applications being returned with payment must be sent to:
Commission on
Rehabilitation Counselor
Certification
Department 4427
Carol Stream, IL 60122-4427
(847) 944-1325

All other correspondence should be
mailed to:
Commission on
Rehabilitation Counselor
Certification
300 N. Martingale Road, Suite 460
Schaumburg, IL 60173
(847) 944-1325

APPLICATION FOR APPOINTING ORGANIZATIONS

Organizations that appoint representatives to sit on the board of CRCC must complete this two-page application and submit payment in the amount of $200.00 in order to receive full approval authority for one calendar year.

Applications must be submitted by December 1 of the calendar year preceding the year for which approval authority is being sought. A late application processing fee of $50.00 will be applied for applications submitted after this date. Indicate if you are submitting a late application processing fee by checking the box below.
Late Application Processing Requested. Requires payment of a processing fee of $50.00.
Organization Information

______________________________________________
Organization Offering Program/Activity

______________________
Sponsor Code (if known)

______________________________________________
Address
______________________
Telephone Number

______________________________________________
City/State or Province/Zip or Postal Code
______________________
Facsimile Number

______________________________________________
Individual Granting Approvals (Must be a CRC or CCRC)
______________________
Organization Website
Documentation to be Submitted At the End of the Calendar Year

A list of the programs/activities approved during the calendar year for which approval is granted to include the following information for each program/activity:
• The program/activity title.
• The location where the program/activity occurred.
• The approval number issued for each program/activity.
Payment Information

CHECKS: Checks must be made payable to CRCC and returned with a completed application and required documentation. A service fee of $35.00 will be assessed for all checks returned for insufficient funds or for charges made to closed accounts. CRCC’s tax identification number is 36-3733179.

CREDIT CARD PAYMENT: All charges for CRCC are processed through the Foundation for Rehabilitation Education and Research. The Foundation will appear on your credit card payment. Complete this section if you wish to charge the fees due to your VISA or MasterCard.

Charge U.S. $ ____________ to my ____ VISA ____ MasterCard
Card #__________________________________ Expiration Date____________
Signature________________________________ Date____________________
Statement of Understanding

I hereby certify that I have read, understand, and agree to abide by the requirements as stated within the Continuing Education Pre-Approval Manual. Furthermore, I certify that I have completed the application and will submit the required documentation for the calendar year for which approval is granted by January 31 of the following calendar year.

I understand that CRCC reserves the right to monitor programs/activities for which continuing education approval has been granted and to withdraw such approval for any program/activity that is offered or presented in any manner that is inconsistent with the approval requirements. Furthermore, I understand that CRCC reserves the right to withdraw approval rights from any organization that does not issue approval consistent with the approval requirements. Actions subject to withdrawal of approval rights includes but is not limited to issuing approval numbers for programs/activities offered by other organizations.

I agree to require and review documentation for each program/activity to include the following in order to ensure that the program/activity is consistent with approval requirements:
• One copy of promotional material such as direct mail flyer or marketing brochure.
• A description of the program/activity content area if not contained within the promotional material.
• A copy of the evaluation form to be given to participants.

I also agree to ensure that the program/activity meets at least one of the following domain focus areas:
Ethical Standards or Decision Making Models for Rehabilitation Counselors (13)
Vocational Consultation and Employer Services (01)
Job Development and Placement Services (02)
Career Counseling and Assessment Techniques (03)
Mental Health Counseling (05)
Individual Counseling (06)
Psychosocial and Cultural Issues in Counseling (07)
Foundations and Professional Issues (08)
Rehabilitation Services and Resources (09)
Case and Caseload Management (10)
Healthcare and Disability Systems (11)
Medical, Functional and Environmental Implications of Disabilities (12)
Addictions Counseling (14)
Clinical Supervision (15)

When issuing approval numbers, I agree to ensure that a separate approval number is issued to any programs/activities that are consistent with the focus area for Ethical Standards or Decision Making Models for Rehabilitation Counselors.

I also understand that any approvals granted are valid for only one calendar year (January 1 through December 31). If the program/activity is changed in any way during that year, I agree to issue another approval number, provided the program/activity meets the requirements.
_________________________________________
Authorized Signature		 __________________________
Date
_________________________________________
Printed Name		 __________________________
Title

Rev. 11/06

CRCC

To avoid delay in processing, applications being returned with payment must be sent to:
Commission on
Rehabilitation Counselor
Certification
Department 4427
Carol Stream, IL 60122-4427
(847) 944-1325

All other correspondence should be
mailed to:
Commission on
Rehabilitation Counselor
Certification
300 N. Martingale Road, Suite 460
Schaumburg, IL 60173
(847) 944-1325

APPLICATION FOR EDUCATION, TRAINING AND RESEARCH PROGRAMS

CORE-Accredited Rehabilitation Counselor Education Programs, State Agency Divisions for Vocational Rehabilitation/State Agencies for the Blind and Visually Impaired, the Federal Department of Veterans Affairs, Research and Training Programs, and Regional Continuing Education Programs must complete this two-page application in order to receive full approval authority for one calendar year.
Applications must be submitted by December 1 of the calendar year preceding the year for which approval authority is being sought. A late application processing fee of $50.00 will be applied for applications submitted after this date. Indicate if you are submitting a late application processing fee by checking the box below.
Late Application Processing Requested. Requires payment of a processing fee of $50.00.
Organization Information

______________________________________________
Organization Offering Programs/Activities

______________________
Sponsor Code (if known)

______________________________________________
Address
______________________
Telephone Number

______________________________________________
City/State or Province/Zip or Postal Code
______________________
Facsimile Number

______________________________________________
Individual Granting Approvals (Must be a CRC or CCRC)
______________________
Organization Website
Documentation to be Submitted At the End of the Calendar Year

A list of the programs/activities approved during the calendar year for which approval is granted to include the following information for each program/activity:
• The program/activity title.
• The location where the program/activity occurred.
• The approval number issued for each program/activity.
Payment Information

CHECKS: Checks must be made payable to CRCC and returned with a completed application and required documentation. A service fee of $35.00 will be assessed for all checks returned for insufficient funds or for charges made to closed accounts. CRCC’s tax identification number is 36-3733179.

CREDIT CARD PAYMENT: All charges for CRCC are processed through the Foundation for Rehabilitation Education and Research. The Foundation will appear on your credit card payment. Complete this section if you wish to charge the fees due to your VISA or MasterCard.

Charge U.S. $ ____________ to my ____ VISA ____ MasterCard
Card #__________________________________ Expiration Date____________
Signature________________________________ Date____________________
Statement of Understanding

I hereby certify that I have read, understand, and agree to abide by the requirements as stated within the Continuing Education Pre-Approval Manual. Furthermore, I certify that I have completed the application and will submit the required documentation for the calendar year for which approval is granted by January 31 of the following calendar year.

I understand that CRCC reserves the right to monitor programs/activities for which continuing education approval has been granted and to withdraw such approval for any program/activity that is offered or presented in any manner that is inconsistent with the approval requirements. Furthermore, I understand that CRCC reserves the right to withdraw approval rights from any organization that does not issue approval consistent with the approval requirements. Actions subject to withdrawal of approval rights includes but is not limited to issuing approval numbers for programs/activities offered by other organizations.

I agree to require and review documentation for each program/activity to include the following in order to ensure that the program/activity is consistent with approval requirements:
• One copy of promotional material such as direct mail flyer or marketing brochure.
• A description of the program/activity content area if not contained within the promotional material.
• A copy of the evaluation form to be given to participants.

I also agree to ensure that the program/activity meets at least one of the following domain focus areas:
Ethical Standards or Decision Making Models for Rehabilitation Counselors (13)
Vocational Consultation and Employer Services (01)
Job Development and Placement Services (02)
Career Counseling and Assessment Techniques (03)
Mental Health Counseling (05)
Individual Counseling (06)
Psychosocial and Cultural Issues in Counseling (07)
Foundations and Professional Issues (08)
Rehabilitation Services and Resources (09)
Case and Caseload Management (10)
Healthcare and Disability Systems (11)
Medical, Functional and Environmental Implications of Disabilities (12)
Addictions Counseling (14)
Clinical Supervision (15)

When issuing approval numbers, I agree to ensure that a separate approval number is issued to any programs/activities that are consistent with the focus area for Ethical Standards or Decision Making Models for Rehabilitation Counselors.

I also understand that any approvals granted are valid for only one calendar year (January 1 through December 31). If the program/activity is changed in any way during that year, I agree to issue another approval number, provided the program/activity meets the requirements.
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Authorized Signature		 __________________________
Date
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Printed Name		 __________________________
Title

Rev. 11/06