Newfoundland and Labrador College of Dietitians

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Initial Registration Application

Instructions

In order for this application to be processed you must:

Complete all relevant sections of the form.
Upload/Send all required documents ( see document list below)
Send transcript(s) of marks from university(ies) in sealed envelope or request that the university sends them directly to NLCD.
Incomplete applications will be denied. Applicants should note that approval of a completed application, including all required documents, may take up to four weeks. If your application is denied, your registration fee will be returned and you will be advised of the reason(s) for the decision and the appeal process.
If your cheque is returned for insufficient funds (NSF), the application will be held back until payment is honoured. An incomplete application or NSF cheque will delay the processing of your applications. There is a penalty of $25.00 for NSF cheques.

Required Documents

These documents are required in order to complete the application.

Letter from Internship Coordinator sent directly to NLCD.
Vulnerable Sector and Certificate of Conduct.
Transcripts must be sent to NLCD in a sealed envelope or sent directly to the NLCD.
If your university transcripts do not yet state that you have met degree requirements, provide a letter from the university indicating completion of degree requirements.
Upload professional liability insurance.
Upload copy of government-issued I.D.

Situation Specific Documents

These documents may be required, depending on your situation.

If English is not your first language, proof of English language proficiency may be required.

Members Info

Step 1 of 11

Given Name(s)

Surname

Previous Name

Date of Birth

Gender

Phone

Address

Address Line 2

Country

Province

City

Postal Code

Class of Registration

Step 2 of 11

Class of Registration

Active Registration: Has met basic requirements of the profession and can practise in the profession in Newfoundland and Labrador.

Temporary Registration: A temporary member has met all registration requirements (with the exception of the examination). This application for temporary membership is also the application to take the next sitting of the Canadian Dietetic Registration Examination.

Date license is Needed

To Date

Language Proficiency

Step 4 of 11

Training Language:

Exam Language

Will you be able to provide professional services in (Check all that apply)

English

French

Other

Other language

Academic Qualifications

Step 5 of 11

Please add at least one basic academic qualification record to proceed. Add other education histories if applicable.

Type of Academic Qualification

Institution

Program Type

Year Completed

Address

Country

Province

City

Postal Code

Practical Training

Step 6 of 11

Please add at least one practical training record to proceed. Add other practical training histories if applicable.

Program Name

Program Director

Year Completed

Address

Country

Province

City

Postal Code

Employment

Step 7 of 11

Do you have previous employment as a dietitian in any jurisdiction at any time in the past?

Yes No

For the purposes of assessing the currency of professional knowledge and skills, you are required to self declare your active practice hours?

Yes No

Employer Details

Employer Name

Address

Country

Province

City

Postal Code

Phone

Employer Type

Department

Division/Site/Campus

Position Details

Employment Title

Employment Category

Primary Function

Time Status

Start Date

End Date

Are you engaged in clinical academic qualification / preceptor activity?

Yes No

Professional Liability Insurance

Step 8 of 11

Provider

Policy Number

Effective Date

Expiry Date

Supporting Documents

Step 10 of 11

I will be uploading scanned documents with this application:

Yes No

Item	Uploaded
Professional Liability Insurance - Required		Upload File
Photocopy Of Degree - Required		Upload File
Copy Of Government Issues ID - Required		Upload File

Please find below a list of documents that need to be mailed to NLCD

Transcripts
Vulnerable Sector Check
Certificate Of Conduct

Please send your documents to:
Newfoundland and Labrador College of Dietitians
PO Box 1756 Postal Station C
St. John's, NL, A1C 5P5

Please find below a list of documents that need to be mailed to NLCD

Professional Liability Insurance
Photocopy Of Degree
Copy Of Government Issues ID
Transcripts
Vulnerable Sector Check
Certificate Of Conduct

Please send your documents to:
Newfoundland and Labrador College of Dietitians
PO Box 1756 Postal Station C
St. John's, NL, A1C 5P5

Acknowledgements

Step 11 of 11

In order for your application to be processed, you must submit payment of your registration fee. The registration year runs from April 1^st to March 31^st. For registrants who have never been registered and who are applying for the first time

Active Registration:
- Application Fee: $100 + Active registration $450 = $550
- Application Fee: $100 + $225 After October 1 each calendar year = $325
Temporary Registration:
- Application Fee: $100 + Active registration $450 = $550
- Application Fee: $100 + $225 After October 1 each calendar year = $325

You verify that all statements contained in this application are accurate and understand that a false or misleading statement or misrepresentation may be cause for revocation of your licence.

You agree to keep your account profile up-to-date ( e.g email address current employment information).

You understand that you may be required to provide further documentation and information and undertake other assessments in order to determine eligibility for registration with NLCD and that the regulatory body will contact you if additional documentation is necessary.

You provide consent for NLCD to disclose personal information to third parties and for third parties to disclose personal information NLCD that may be necessary for NLCD to process your application and verify the information that you have provided.

You are aware that you may not practice or use protected titles Registered Dietitian of the initials RD in Newfoundland and Labrador until you have been formally notified by NLCD that you are entitled to do so.

You are aware that you have not begun employment as a dietitian until you have been formally notified by NLCD that your application has been approved.

You are aware that personal information requested on this form is used for purposes of administration of Labour Mobility Agreements with other regulatory authorities, administration of the Canadian Dietetic Registration Examination, and generally for regulatory activities under the Dietitians Act.

You consent to the collection use and disclosure of your personal information for such purpose.

I authorize NLCD to request release of information in relation to this application.

I authorize NLCD to send emails regarding educational opportunities.