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ECCUs REQUEST FORM

Highlighting supervisor's contribution to the academic community

GENERAL INFORMATION

Name

First Name

Profession

Preferred language

Current workplace

Are you a CCNB graduate?

Yes

Institution where diploma was obtained

Academic level completed

College certificate

College diploma

Advanced college diploma

Undergraduate

Master's

Doctorate

In which program

Graduating year

How many years have you been doing supervision?

Did you supervise students from CCNB?

Yes

For administrative purposes, please indicate whether your occasionally supervise students from other institutions (colleges / universities)

Yes

If so, please identify these institutions

Is this your first request for obtaining ECCUs? (You can ask for recognition of activities in which you took part over the last five years)

Yes

Complete this form to be part of our database and obtain supervisory titles based on the ECCUs you have accumulated. You can apply for recognition in which you have been involved over the past five years. Fill all the text boxes that apply to your situation.

SUPERVISION (Students from Collège communautaire du Nouveau-Brunswick (CCNB))

Traditional Model
(One supervisor and one student)

50 ECCUs

5 days, cumulative or continuous

100 ECCUs

> 1 week and ≤ 4 weeks

150 ECCUs

> 4 weeks

Co-supervision Model
(Two supervisors and one student)

50 ECCUs

5 days, cumulative or continuous

100 ECCUs

> 1 week and ≤ 4 weeks

150 ECCUs

> 4 weeks

Triad
(One supervisor and two students)

300 ECCUs

≤ 4 weeks

350 ECCUs

> 4 weeks

Observation Practicum

50 ECCUs

5 days, cumulative or continuous

Group Supervision

50 ECCUs

per student, maximun of 500 ECCUs

Identify the supervision activities during the last five years. Identify the type of supervision, the number of students and approximated dates. (You can ask for recognition of activities in which you took part over the last five years)

CONTINUING EDUCATION (Did you attend any continuing education?)

The Art of Supervising Trainees and other professional trainings
(of the CNFS - Volet Université d'Ottawa)

Online

30 ECCUs

per training

In class

100 ECCUs

two days

50 ECCUs

one day

20 ECCUs

one workshop (2 to 3 hours)

Other supervision training
(non CNFS)

In class/Online

100 ECCUs

two days

50 ECCUs

one day

20 ECCUs

one workshop (2 to 3 hours)

Active
(Offer from a CNFS member)

30 ECCUs

Annual Conference on Health and Wellness
of the CNFS - Volet Université d'Ottawa

50 ECCUs

Professional Excellence Program (PEP)
of the CNFS - Volet Université d'Ottawa

10 ECCUs

per PEP

Identify all continuing education activities during the last five years. Identify the titles, methods, duration and dates. (You can ask for recognition of activities in which you took part over the last five years)