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BCRSP Application

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Application for Canadian Registered Safety


Professional CRSP Designation

PLEASE READ THE ENTIRE APPLICATION FORM


BEFORE YOU BEGIN COMPLETING EACH SECTION

PLEASE COMPLETE AND SUBMIT ORIGINAL AND ONE COPY OF APPLICATION FORM
AND ONE COPY ONLY OF SUPPORTING DOCUMENTATION ALONG WITH THE NON-REFUNDABLE
APPLICATION FEE TO:
Board of Canadian Registered Safety Professionals
6700 Century Ave Suite 100
Mississauga, ON L5N 6A4

FEES:

R#100304195

Non-Refundable Application Fee $525.00 + HST/GST


Residents of AB, BC, SK, MB, QC, YT, NT, NU Add 5% GST ($525.00 + $26.25 = $551.25)
Residents of ON, NB, NL Add 13% HST ($525.00 + $68.25 = $593.25)
Residents of PEI Add 14% HST ($525.00 + $73.50 = $598.50)
Residents of NS Add 15% HST ($525.00 + $78.75 = $603.75)

Residents outside of Canada - $525.00


Application Fee Credit Card Payment:
Name of Applicant:
Payment By:
Card #

American Express

Province of Residence:
MasterCard

Visa

Cardholders Name:

Expiry Date:
CVV#:
I authorize a $525.00 + HST/GST charge to the credit card noted above.
Signature:
Payment By:
Cheque enclosed made payable to the BCRSP
Payment Online:
If you submitted your payment via the BCRSP website, please enclose a copy of the
receipt delivered to you via email.
Applications submitted electronically or via facsimile or handwritten submissions will not be accepted.
Please do not cerlox-bind your submission.

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BCRSP Application

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BCRSP Application Requirements


Before submitting your application, please ensure that all sections of the application (Parts A, B, C and Factors 1,
2, and 3) are completed in full and the Declaration is signed and dated. Supporting documentation must be
clearly identified by Factor and attached in the same order as listed on the application.
Applications that are not fully completed with documentation attached and in the proper order will be
returned to the applicant for resubmission. A $50.00 (+ HST/GST) resubmission fee must accompany the
resubmitted application.
Chronological resumes should be submitted with your application however, they are not considered official
documents but may be used by the Qualifications Review Committee to clarify formal education and employment
information and dates.

International Applicants
International applicants whose first language is neither English nor French must:

Submit documentation verifying a minimum score of 94-101 on a Test of English as a Foreign


Language (TOEFL) IBT; a band score of 7 on the International English Language Testing Sytem or
a score of 785-900 on a Test de franais international (TFI). (Equivalent proof of language
proficiency (e.g. a university assessment) will also be accepted)
Foreign credentials must be translated to English or French and be verified by an official translator
Foreign credentials must be submitted to a Canadian Credentialing Agency (see below) prior to
application submission.

Foreign Credential Assessment and Evaluation

Alliance of Credential Evaluation Services of Canada (Pan-Canadian) www.canalliance.org/indexe.stm


Canadian Association of prior Learning Assessment (Pan-Canadian) www.capla.ca/news.php
Canadian Information Centre for International Credentials (Pan-Canadian) www.cicic.ca
University of Toronto Comparative Education Service (Pan-Canadian) www.adm.utoronto.ca/ces
International Qualifications Assessment Services (AB, SK, NT)
www.employment.alberta.ca/cps/rde/xchg/hre/hs.xsl/4512.html
British Columbia Institute of Technology - International Credential Evaluation Services (BC)
www.bcit.ca/ices
Academic Credentials Assessment Service (MB)
www2.immigratemanitoba.com/browse/work_in_manitoba/work-recognition-acas.html
World Education Services (ON with pan-Canadian applicability) www.wes.org/ca/employers/index.asp
Centre dexpertise sur les formations acquises hors du Qubec (QC) www.immigrationquebec.gouv.qc.ca/en/education/comparative-evaluation/index.html

Reference :

The Employers Roadmap, Hiring and Retaining Internationally Trained Workers


Citizenship and Immigration Canada
Foreign Credentials Referral Office
C&I-1019-05-09E
www.credentials.gc.ca

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BCRSP Application

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APPLICATION FOR CERTIFICATION


It is the responsibility of applicants to review the BCRSP Application & Eligibility Requirements
document before completing the application form. International applicants are reminded to review the
requirements for application submission.
Please note:
If you have submitted your certification application, you may advise prospective employers that you have made
application to the Board of Canadian Registered Safety Professionals. You may NOT indicate that you are a
CRSP, a candidate CRSP, an applicant CRSP, a CRSP in process or a pending CRSP. The designation may
not be used until such time as you have successfully completed the certification process, been awarded the
designation by the Governing Board and received verification of certification (certificate and ID card).
Unauthorized use of the CRSP prior to Governing Board approval and receipt of proof of certification may result in
a the application process being terminated.

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BCRSP Application

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Part A: Personal Information


Salutation

Mr (Please select via drop down list)

Last Name

First Name

Employer

(Current employer information


must be completed)
Your Position/Title

Business Address

City

Province

Postal Code

Business Telephone

()

Email

Home Address

City

Province

Postal Code

Home Telephone

()

Preferred Mailing Address

Business

Home

It is the applicants responsibility to keep the BCRSP informed of any changes to the above information.

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BCRSP Application

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Part B: Reference Questionnaire (RQ)


Please provide the name, title, employer, telephone number and email address of your reference. When selecting
your reference, be sure this individual has knowledge of the OHS work you have done and the degree of
responsibility you have in the administering of your employers OHS program. You may not use anyone as a
reference over whom you have supervisory responsibilities. It is not necessary that your reference be a Canadian
Registered Safety Professional (CRSP).
The completed Reference Questionnaire is NOT to be returned to the applicant, but sent directly to the Board. A
Reference Questionnaire included with an application will not be considered and a new reference will be
requested.
Contact Information for the Individual Completing the Reference
Name

Title

Employer

Telephone (with area code)

Email

Part C: Practice Questionnaire (PQ)


Please provide the name, title, employer, telephone number and email address of your immediate supervisor. If
you are a private consultant, the Practice Questionnaire may be completed by a current client.
The completed Practice Questionnaire is NOT to be returned to the applicant, but sent directly to the Board. A
Practice Questionnaire included with an application will not be considered and a new Practice
Questionnaire will be requested.
Immediate Supervisor/Client Completing the Questionnaire
Employer
Name

Title

Employer (only if client)

Telephone

Email

Client

The same individual may not complete both the Reference Questionnaire and the Practice Questionnaire
on behalf of the applicant.

May 2014

BCRSP Application

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Factor 1 : Formal Education


Minimum points required = 50; maximum points available = 100
Minimum requirement: a one year college/university certificate/diploma in OHS OR a two year college/university non OHS
certificate/diploma.
Formal Education

Value

OHS
**One year OHS college or university certificate or diploma

50

Two year OHS college or university certificate or diploma or one year post diploma

70

Three year OHS college or university certificate, diploma or degree

80

Four year OHS college or university diploma or degree

100

Post graduate OHS degree

100

NON-OHS
**Two year non-OHS college or university certificate or diploma

50

Three year non-OHS college or university certificate, diploma, degree or one year non-OHS post diploma

60

Four year non-OHS college or university diploma or degree

70

Post graduate non-OHS college or university degree

80

Applicants who completed formal education above the minimum requirement (e.g. undergraduate degree or college diploma in
any discipline) meet the formal education requirements for certification. All completed post-secondary education programs may
be claimed to a maximum of 100 points as follows:

The highest level of completed formal education will be awarded the maximum number of points as per the matrix
below
Each additional level of completed formal education will be awarded 50% of its point total
Specialty certificates/diplomas/degrees within the scope of OHS practice should be claimed as non OHS programs
(i.e. kinesiology, ergonomics, environment, etc). OHS programs must be generalist in content reflecting the CRSP
generalist designation as outlined in the Examination Blueprint.
Program length is based on full-time attendance. If you are enrolled as a part-time student and it takes two to three
years to complete what is a one year program for a full-time student, you must claim it as a one-year program.

To receive Factor 1 credit, applicants must request granting institution to provide a final sealed transcript. Transcripts that
have been photocopied or scanned will NOT be accepted.

Level Completed

One year OHS college


or university certificate or
diploma
Two year non- OHS
college or university
certificate or diploma

College/University

Program Name

Year Graduated/
Completed

QRC
Use
Only

May 2014

BCRSP Application

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Factor 1 : Formal Education


Minimum points required = 50; maximum points available = 100
Minimum requirement: a one year college/university certificate/diploma in OHS OR a two year college/university non OHS
certificate/diploma.
Two year OHS college or
university certificate or
diploma or one year post
diploma
Three year non- OHS
college or university
certificate, diploma, degree
or one year non-oh&s post
diploma

Three year OHS college


or university certificate,
diploma or degree
Four year non- OHS
college or university diploma
or degree

Four year OHS college


or university diploma or
degree
Post graduate OHS
degree
Post graduate non- OHS
college or university degree

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BCRSP Application

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Factor 2 : Professional Development


Minimum points required = 15; maximum points available = 100
List all OHS-related training courses/seminars/conferences you have completed beginning with the most recent. To obtain
credit, you must attach a copy of the course/seminar/conference outline that shows the title of course, length of course, name
of course provider, and a copy of any certificate received or furnish equivalent proof of completion such as a letter from the
organization presenting the course/seminar/conference.
Professional development credits will not be granted without documentation. Documentation must be attached for each
course/seminar/conference in the same order as listed on the application. If you do not have supporting documentation, do
not list the professional development activity on your application.
In-house training will be considered, however, applicants must provide verification from their employer of course dates, content
and successful completion. Orientation training to meet job requirements may not be claimed in Factor 2.
IMPORTANT: The time limit for Category A1 and A2 professional development activities is five (5) years or 60 months.
(The 5 years (60 months) is calculated from the date the application is received by BCRSP.)
There is no time limit for Category B OHS credit courses. Individual courses from completed OHS certificates cannot be
claimed under Factor 2.
Online Courses:
Points may be awarded based on technical contact time as identified by the course provider, not the actual contact time for the
applicant completing the activity. If the course provider cannot provide contact time for the activity, no points will be
awarded.
Activity

Value

A1. OHS courses/seminars/conferences of a minimum one day (6


hours) duration

1 point/day

A2. Non OHS course/seminars/conferences of a minimum of one day


(6 hours) duration

1 point/day (to a maximum of 5 points)

B. College/university OHS credit course (not part of formal education


Factor 1)

10 points/course

A1.

OHS courses/seminars/conferences, minimum of one day (6 hours duration) completed in the last five years

(60 months).(from the date of application received)


Course Provider

Title of Course /
Seminar / Conference

Total
Hours

Start/Finish Dates

QRC Use
Only

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BCRSP Application

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Factor 2 : Professional Development


Minimum points required = 15; maximum points available = 100
List all OHS-related training courses/seminars/conferences you have completed beginning with the most recent. To obtain
credit, you must attach a copy of the course/seminar/conference outline that shows the title of course, length of course, name
of course provider, and a copy of any certificate received or furnish equivalent proof of completion such as a letter from the
organization presenting the course/seminar/conference.
Professional development credits will not be granted without documentation. Documentation must be attached for each
course/seminar/conference in the same order as listed on the application. If you do not have supporting documentation, do
not list the professional development activity on your application.
In-house training will be considered, however, applicants must provide verification from their employer of course dates, content
and successful completion. Orientation training to meet job requirements may not be claimed in Factor 2.
IMPORTANT: The time limit for Category A1 and A2 professional development activities is five (5) years or 60 months.
(The 5 years (60 months) is calculated from the date the application is received by BCRSP.)
There is no time limit for Category B OHS credit courses. Individual courses from completed OHS certificates cannot be
claimed under Factor 2.
Online Courses:
Points may be awarded based on technical contact time as identified by the course provider, not the actual contact time for the
applicant completing the activity. If the course provider cannot provide contact time for the activity, no points will be
awarded.

A2.

Non OHS courses/seminars/conferences, minimum of one day (6 hours duration)., to a


maximum of 5 points completed in the last five years.
Course Provider

B.

Title of Course /
Seminar / Conference

Total
Hours

Start/Finish Dates

College or university credit courses having a minimum duration of one full semester (35
hours). College/university original transcript must be received in order to receive credit. Do not
include courses completed for formal education programs claimed in Factor 1.
College/University

Course

Total
Hours

Start/Finish Dates

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BCRSP Application

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Factor 3: Professional Practice (Related Experience)


Minimum points required = 50; maximum points available = 100
Credit will be given for each year of continuous OHS employment to a maximum of eighty-five months (seven years). The
minimum requirement for registration is thirty-six months (three years).
NOTE: University/college/co-op work terms may not be applied to professional practice.
The Qualifications Review Committee evaluates each job position using the criteria listed on the Professional Practice
Experience Form to determine whether it is accepted as professional practice. Failure on any one means that the position is
not accepted.
You must complete a Professional Practice Experience Form for each position listed below for which you are seeking
credit. Do not overlap time periods.

Note: Gaps in employment due to parental leave, LTD, returning to school full-time, unemployment, etc, to a
maximum of 12 months will not negate the 36-month continuous employment requirement but must be identified
on the application. Employment gaps of more than 12 months will be assessed on a case-by-case basis.
Full-time OHS related experience

Value

Minimum 36 months (3 years)

50

37-60 months (3 years - 5 years)

65

61-84 months (5 years - 7 years)

80

85+ months (7+ years)

100

Current Resume is Enclosed with Application


Employer

Job Title

Dates
Employed
(Month/Year
to
Month/Year)
Do not
overlap
months

Current
Employer

1st previous
employer

2nd
previous
employer

3rd previous
employer

Professional
Practice
Experience
Form
Enclosed

Job
Description
enclosed

Employer
verification
letter
enclosed

QRC Use
Only

May 2014

BCRSP Application

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DECLARATION
I certify that the information contained in this application and all documents attached thereto, are factual and
accurate to the best of my knowledge and hereby request assessment by the Qualifications Review Committee. If
approved to proceed with the certification process, I agree to present myself at a Regional Screening Centre of
my choice for interview. If approved to write the certification examination (CRSPEX), I understand that the
examination is a computer based test (CBT) based on the Examination Blueprint and administered at third party
test centres contracted by the Board. I agree to abide by the Boards Code of Ethics and understand that the
Governing Board shall be the sole authority as to who shall and who shall not be approved for certification.
Signature:
Date:

Application Assessment
The final determination of the acceptability of an applicant to proceed to a Regional Screening Centre interview is
made by the Qualifications Review Committee. Applicants should not assume that their assessment of points
awarded in Factors 1, 2 and 3 will be the same as that of the Qualifications Review Committee.
A minimum total of 150 points from all three Factors is required for a applicants to proceed in the certification
process. Applicants must obtain a minimum of 50 points in Factor 1 (Formal Education), 15 points in Factor 2
(Professional Development), and 50 points in Factor 3 (Professional Practice).

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BCRSP Application

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QUESTIONNAIRE (Optional)
Your response to the following would be appreciated
How did you hear about the CRSP designation?
Colleague
Employer requirement
Job advertisement
Trade show exhibit (please specify which trade show):
OH&S Conference Presentation (please specify which conference):
Magazine advertisement (please specify which publication):
Website
Educational institution
Other (please specify):

May 2014