Board of Examiners Application Form 2020
Please print or type all information and enclose résumé.
APPLICANT INFORMATION
Name:
Registration Number:
Employer:
Position/Title:
Does your workplace support your involvement in the Board of Examiners?
Address City, Province Postal Code:
Preferred Telephone # Email:
GENERAL CRITERIA- Things to consider before you apply
Are you • A registered physiotherapist in good standing in Canada
• Familiar with commonly accepted standards of practice for physiotherapists
• Familiar with entry-level requirements for physiotherapists in Canada
• Able to think critically and work well in groups
• Currently working in direct clinical practice
• Available for approximately 5 teleconferences of 2hrs in length in July/early August and December/mid-January. The member must be available for all teleconferences, times are 1:00-3:00PM EST
SPECIFIC PROFILE OF EXPERIENCE/BACKGROUND
Years of experiencePhysiotherapy Sector Experience
Physiotherapy Practice Settings
Clinical Areas of Practice Client Groups
□
Educational□
Community Care□
Musculoskeletal□
Child (0-18)□
Professional□
Extended Care□
Neurological□
Adult (19-64)□
Regulatory□
Private Practice□
Cardiovascular-respiratory□
Senior (65+)□
Acute Care□
Rehabilitation CentreSignature: Date:
Please return completed form by email to laura.segal@alliancept.org by March 2, 2020
•
The selected physiotherapist will be informed within a month from the application deadline date and will be expected to be available for training in May for a start for the June exam.
•
