California Board of Recreation and Park Certification, Inc

P.O. Box 900489 Palmdale CA. 93590-0489 

                                        Phone: 661-538-1332 Fax: 661-274-8600  email: cbrpc@roadrunner.com 

FORMS

      
RTC, RC CERTIFICATION APPLICATIONS

This includes Recreation Therapy and Recreator Certified Applications, Recreation Therapy Assistant Registered Application, Texas Certified Recreation Therapist Transfer Certification from Texas to California, Transferring California Certification to Texas Certification, Previously Certified Re-Entry as a Recreation Therapist Certified and New Recreation Therapy Internship Agency Applications.

RTC RECREATION THERAPIST CERTIFICATION IMPORTANT: This application is specifically for individuals with a  Bachelors, Master's and or Doctoral degree in Recreation Therapy.  No other degrees or experience will be accepted. Students having graduated after 2009 must complete an internship - work experience will not substitute for an internship. Internships must be under the supervision of a certified recreation therapist - RTC. 

FYI: Students are required to complete a minimum 600 hour internship. (Board approved 3/12/15). 


       


RTC - RECREATION THERAPIST CERTIFIED APPLICATION
 

 Click here to view, copy or upload  2016 RT Application & Payment Forms in word

 Click here to view, copy or upload  2016 RT Application & Payment Form as a pdf. file

We recommend supplementing one or both recreation therapy text Books to go with Study Guide; which is merely that, a guide.  We also recommend getting into study groups.  The study guide order form is also part of the Recreation Therapy Application or click on the link below for the study guide order form.

Click here to view recommended text books

DISCLAIMER: The Recreation Therapy Certified Examination Study Guide has been developed to assist the applicant in preparing for the CA Board of Recreation and Park Certification and the Consortium for Therapeutic Recreation/ Activities Certification Examination.  It is designated to facilitate the review of the most recent university course material and therapeutic recreation texts and doe not guarantee the applicant will attain a passing score on the examination.  The study guide was developed and written by educators as were our examination questions.

Click here for the RT or RC Study Guide Order Form

ABSOLUTE DEADLINE for Application: 
   Spring: Last Friday of January: Examination given during the month of April 
   Fall 3rd Friday of August: Examinations given during the month of November 
   


      


PCRE PREVIOUSLY CERTIFIED RTC RE-ENTRY APPLICATION & PAYMENT FORM

Recreation Therapist Certified previously through our board has already proven they are qualified, sat and passed the exam and let their certification lapse.  To re-enter as a CBRPC Recreation Therapist Certified the following requirements must be completed.

- Earned 2.0 (20 hours) of CEU's related to our profession and within the past 2 years of the year you are re-entering.  Contact office for exact dates.
-Pay the fee (see application)
- CEU details provided in the attached form below.
-Re-taking the exam is not an option.

Click to view and upload

Accepted CEU's for the RTC Previously Certified Re-Entry
Click here to view and copy

RC - RECREATOR CERTIFIED APPLICATION
This application is for recreation and tourism studies management students and professionals. It is an entry level examination and requires a bachelors or masters degree in a related field. 

RC- Recreator Certification Application Information and Payment Form
Click here to view and copy

ABSOLUTE DEADLINE for Application Review: Spring: Last Friday of January Fall 3rd Friday of August         

RTAR - RECREATION THERAPY ASSISTANT REGISTERED APPLICATION 
This is for individuals who have not received a specific degree from an accredited University in Recreation Therapy/Therapeutic Recreation. There are specific college/university courses required and experience in the field does count. This registration is specially designed for the para-professional/activity director.  This does not take the place of certified recreation therapists.  

    

RTAR- Recreation Therapist Assistant Registration Application Information and Payment Form
Click here to open and copy

ABSOLUTE DEADLINE for Application Review: Spring Last Friday of January Fall 3rd Friday of August

California State Universities where you can obtain a certificate in Recreation Therapy:

CSU East Bay      Dr. Eric Kong, PhD 
  25800 Carlos Bee Blvd. Hayward, CA 94542
  510-885-4710

CSU Long Beach  Dr. Terry Robertson  email: terry.robertson@csulb.edu
  1250 Bellflower Blvd. Long Beach, CA 90840-4903
  562-985-4079

- CSU Fresno        Dr. Nancy Nisbett, PhD   email: 559-278-6807
  5310 N. Campus Drive  M/S PH103 Fresno, CA 93740-8019
  559-278-6807

San Jose State University   Dr. Susy Ross, PhD   email: susy.ross@casa.sjsu.edu
  One Washington Square San Jose 95192-0060
  408-924-3007


Sample Course Titles from CA State University (CSU) Recreation Therapy Programs
 Click here to view and copy




Texas Certification Transfer from Texas to California
This is for Recreation Therapists who are certified through Texas and have relocated in CA; your certification is transferable to RTC.  Review and complete the attached form.

Texas Certified Recreation Therapist Transfer Certification from Texas
 to California
Click here to view and copy





California Certification Transfer from California to Texas
This is for RTC's who relocate from California to Texas; your certification is transferable to Texas Certification.  Save yourself time and energy and complete this before your move.  Should you have any questions about the form or process contact: Kelly (Tuesday or Thursday) at 512-928-2292 or email questions to Info@ctractexas.org

Caifornia RTC Transfer to Texas
Click here to view and copy

2016 University Renewal Form.pdf
0.5 MB
Spring 2016 Internship Agency Renewal and Payment Form.pdf
0.6 MB

Recreation Therapy Fieldwork Internship
Agency Application Form

This is for an agency who would like to train and supervise university recreation therapy internship students who are in their last semester and required to complete an internship with CBRPC, Inc approved agency. 

The applying agency must have state and nationally certified recreation therapists who will be responsible for the training and direct supervision of our CA University students.  There are specific requirements developed by our state universities that ensure our students receive quality internships.

This form can  also used for Agencies that were approved missed there renewal and are now expired and want to come back in as a CBRPC approved certified agency.  The application has been updated and made more user friendly.  The completed application and supplemental information is to be no more than 50 pages and when complete sent to cbrpc@roadrunner.com as a pdf attachment which will be emailed to the committee reviewing the new applications.
 

Updated 3-15-15 
Recreation Therapy Fieldwork/Internship Agency Application and Payment Form

Click here to view and copy


Use of Preceptor for RT Fieldwork Internship Agency Guidelines
This form is specifically designed for an agency who is not certified for intern students and does not have a state certified recreation therapist on staff and would like to have their agency certified for a student intern and wants to use someone who is state certified and has agreed to be the agency preceptor with the understanding that one or more staff will become state certified and apply for an RT/TR Agency Application within 2 years.  Please read and review the guidelines, which is available in the Agency Application Form.


LIFE/RETIRED CERTIFICATE APPLICATION INFORMATION
This application is for the current certificant (10 years or more) who is going to or is retired and no longer a practicing recreation certified professional or a practicing recreation therapist part-time or full-time in the field.  When the certificant is granted a Life Certificate they cannot use it to show they are currently certified to work in the field.  Once the Life Certificate has been granted and the certificant wants to go back to work part time or full time in the field, they must notify the office, become re-certified and begin earning 2.0 CEU's which will come due in 2 years from the time they re-enter as a certified RC or RTC.  

The Life Certificate does not authorize work in the field and is illegal to do so; it indicates the individual is a Life Certificant was in good standing and is no longer working in the field and awarded RRTC Retired Recreation Therapist Certified or RRC Retired Recreator Certified which, once Executive Board approved, can be placed behind their last name. 


Life/Retired Certificate Application
Click here to view, upload and copy



 
RT/TR Student Internship Fall 2017 Agency Renewal FORMS

FALL 2017, for agencies whose certificate expires September 30, 2017
Complete the first page & Payment form and the Personnel Qualification forms for each RTC/CTRS new staff person working with students. 

Any renewal form received after August 16, 2017 is late and charged the late fee.
Forms received after September 30, 2017 are considered expired.  To reinstate, must complete the New RT/TR Agency Application Form and go through the complete process. 

   

Fall 2017 RECREATION THERAPY INTERNSHIP AGENCY RENEWAL & PAYMENT FORM  
  
Click here to view, download or copy pdf  
 
  
Click here to view, download or copy word
CBRPC Internship Agency Application 10-26-16.doc
188.5 KB


DECEMBER 2017 RENEWALS COMING SEPTEMBER 1, 2017
Dec. renewals increased to $100 by check/ MO and $105 by VISA or MasterCard
Late fee: (check/MO) $156.00 - (Visa/MasterCard) $161.00
RTC/ RC / RTAR December 2017 Basic Renewal Information
Once all the renewals are complete, this information is provided on the website.
The Recertification Review Committee meets in Sacramento the first week in December to review all renewals.  Results mailed out that Friday evening in plenty of time before the certificant's certification expires December 31, 2016

RTC/RC certificate and or Verification of 2.0 (20 hours) CEU's or Contact hours earned include:
Accepted CEU's for RTC Renewals:
Click here to view and copy
CEU Certificate validation format to include:

-Name of CEU Provider/Workshop/Institute/Conference
-Location/ Date and Time
-Your name must appear on the CEU verification form
-Session Title(s)/ length of each session (1hr/ 1.5 hrs/ 2 hrs/ 3 hrs)
-Number of CEU(s) pr Contact hours earned
-Monitor/sponsor of session/workshop/institute verifying initials and or signature
Proof of publications (published text books, articles in professional magazines etc- make a copy of the front of the text book and the page showing the date it was published, publishing company and authors name. For an articles; make a copy of the front of the Magazine it was published in, the table of contents and article that has your name as the author on it. All
publications must directly relate to your certification.

JUNE 2017 RENEWALS
 
 FYI: 
 June 2017- renewals increased to $100 by check/ MO and $105 by VISA or MasterCard
 Late fee: (check/MO) $156.00 - (Visa/MasterCard) $161.00


 
IMPORTANT: RTC/RC certificate and or Verification of 2.0 CEU's or Contact hours earned  include:
  Accepted CEU's for RTC Renewals:
  Click here to view and copy

  CEU Certificate validation format to include:

 
-Name of CEU Provider/Workshop/Institute/Conference
  -Location/ Date and Time
  -Your name must appear on the CEU verification form
  -Session Title(s)/ length of each session (1hr/ 1.5 hrs/ 2 hrs/ 3 hrs)
  -Number of CEU(s) pr Contact hours earned
  -Monitor/sponsor of session/workshop/institute verifying initials and or signature
The 2.0 CEU's (20 hours) for June 2017 Renewal cycle must fall between June 1, 2015 to May 21, 2017
  Proof of publications (published text books, articles in professional magazines etc- make a copy of the front of the text book
  and the page showing the date it was published, publishing company and authors name.  For an articles; make a copy of the
  front of the Magazine it was published in, the table of contents and article that has your name as the author on it.  All
  publications must directly relate to your certification.

  (postmarked) May 21, 2017 to allow time to process and prepare documents for the RRC Recertification Review
  Committee.  The committee carefully reviews each and every renewal, results mailed out the end of the day.  If there is a
  concern, the committee member reviewing the renewal will call the same day; and additional information required is generally
  due within 20 days of the call or before the expiration date of June 30, 2017  

  JUNE 2017 Renewal Forms

  
     
IMPORTANT:
  Renewals received (postmarked) May 21 is considered late and late fee applies and review may take
  an additional month to review.


  RTJUNE 2017 Renewal & Payment Form 
   Packet includes Professional Leave of Absence, Extension, and not planning to renew forms.
  RC JUNE 2017 Renewal & Payment Form               
  Packet
include Extension, and not planning to renew Forms
   RTAR JUNE 2016 Renewal and Payment Form

MISCELLANEOUS

Name change, address or email change:

If you have changed your name, mailing address or email change- you are asked to cmplete the following form and return it to the office as soon as possible.  The office is not responsible for not getting informtion to you if your information has changed.

Name, Address, Phone or email Change Form
Click here to view and make a copy



Certificate, Wallet Card, Lapel Pin Replacement and Payment Form
Click here to view and copy



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