Appendix 23 – Course Developer CEC Course Evaluation Form

Appendix 23 – Course Developer CEC Course Evaluation Form

***PLEASE NOTE We require ALL requested information. If all information is NOT provided, we will be unable to assess the course. ****
Submitted By:
Name*

First NameLast Name
Email*
example@example.com
Telephone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Course Information:
Course Name*
Name of Course Developer*
Course Date (if applicable)

MonthDayYear
Date
Course Location (if applicable)
Total Hours of Course*
**including all theory and practice hours**
Specification of Instructor to Student Ratio (for in person or live online instruction)
Course Registration Information:
Email Address*
example@example.com
Website Address*
Telephone Number*
Social Media Profiles Associated with Course

If the course is approved for CEC’s, your course will be mentioned and tagged in a future social media post as having received approval by the Association.
Facebook
example: @cmmotacanada
Instagram
example: @cmmotacanada
X (formerly Twitter)
example: @CMMOTACanada
Linked In
example: @cmmotacanada
Course Developer Continuing Education Credits Evaluation Requests by members are subject to a fee of $35 or by non-members are subject to a fee of $70 per course as prescribed in the CMMOTA Fee Schedule. This fee MUST be paid PRIOR to the course being reviewed for approval.

Continuing Education Guidelines for New Courses for Course Developers

New Course Guidelines and Checklist:

Qualifying: Course Developer must meet ONE (1) of these listed credentials (please attach proof):
- Must have Three (3) years of professional practice related to the specific field of study AND must have Educational Certification with a minimum of two (2) completed courses related to the specific field of study.
- Must have Three (3) years of professional practice related to the specific field of study AND must have two (2) letters of support from reputable Colleagues (aka Peer Review)
- Must have Education Certification with a minimum of two (2) completed courses related to the specific field of study AND must have two (2) letters of support from reputable Colleagues (aka Peer Review)
- Eight (8) years of Professional Practice related to the specific field of study/modality (Letter of Good Standing from Association OR Certificates of Association Membership accepted as proof)
- Educational Certification with a minimum of three (3) completed courses related to the specific field of study (modality), one (1) of which includes some sort of training to be a workshop facilitator
- Has been certified by the National Certification Board for Therapeutic Massage and Body Work as an Approved Provider for Continuing Education (US Designation)
- Recognized in the field of study as an expert (only for courses not classified as technique/modality/refresher in nature)
Please ensure all the information provided is accurate.
Teaching Experience: (please check ALL that apply for the course developer listed above, and attach proof with submission of this form)*

TA ExperienceAssisted with a minimum of 3 classesCEC in the field of study8 years experience in Education/Practice/TeachingBachelor’s Degree related to field of studyMinimum of 3 year’s Experience in the field of study/modalityCertified by the National Certification Board for Therapeutic Massage and Bodywork as an Approved Provider for Continuing Education or similar body pertaining to the field of study.
Please upload your Teaching Experience proof here:*

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Additional Documentation Required
Please Provide:
- Proof of Certification(s) related to field of study: (Please provide copies of the course developer’s certifications related to the course)
- Course Developer Biography / Resume that clearly outlines expertise and education to adequately teach this course, along with any certifications that support the training obtained to be teaching this course.
- Contraindications & Safeties a full list is required.
- Hourly outline of course length, including lunch and breaks for all days
- Detailed description of course, including what the participants are taught, what they will learn, clinical skills after completion, any additional skills learned throughout the course, and method of learner evaluation.
- Sample copy of the Certificate of Completion this is for insurance purposes only and to ensure we have the correct name for the course.
- Requirements for Case Studies, if applicable. Are the case studies required before receiving the certificate?
Please upload your Additional Documentation Here:*

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Cost:

Course Developer Continuing Education Credits Evaluation Requests by members are subject to a fee of $35 or by non-members are subject to a fee of $70 per course as prescribed in the CMMOTA Fee Schedule. This fee MUST be paid PRIOR to the course being reviewed for approval.

Payment:
Payment: Please E-Transfer to payments@cmmota.com and make the security answer membership. Please contact our office to arrange another form of payment.
Additional Comments for Course Consideration:
DISCLAIMER - Should the Association (CMMOTA) choose to recognize this course as value for continuing education credits, it does not mean that any professional liability insurance provider will recognize the course as substantive for providing coverage for the practice of a modality or technique which may be attained within the training received. Further, the Association (CMMOTA) shall hold no responsibility non liability for the content or accuracy of information which may be presented through this continuing education course, nor is approval of continuing education credits to be taken as an endorsement of the continuing education course, nor does any material presented through the continuing education course necessarily represent the views, values, or mission of the Association.

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Appendix 23 – Course Developer CEC Course Evaluation Form

Submitted By:

Course Information:

Course Registration Information:

Social Media Profiles Associated with Course

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