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Career Documentation

CURRICULUM VITAE
Curriculum Vitae: An account of ones career and qualifications

BIOGRAPHICAL Name: Home Addre : Bu ine Addre : Bu ine Phone: &a': Birth Date: !ocia" !ecurit# $: E%mai" Addre : Ce""u"ar Phone:

EDUCATION List all post-secondary education completed in reverse order: Institution name Institution address Degree earned, year of graduation/completion Concentration of study Dates attended
Date Attended De(ree and )ear Earned Concentration o* !tud# In titution In titution Addre De(ree and )ear Earned Concentration o* !tud# In titution In titution Addre

Date Attended

LICEN!URE AND CERTI&ICATION List all licenses and certifications you old! Include: Licensing or certifying organi"ation #state $oard, professional organi"ation, etc!% License or certificate num$er Dates

Certi*#in( Or(ani+ation Certi*#in( Or(ani+ation

Licen e , Certi*icate Num-er Licen e , Certi*icate Num-er

Date Va"id Date Va"id

&'aintain separate ard copy files of all certificate and license information PRO&E!!IONAL E.PERIENCE List relevant (or) e*perience including positions ( ic are academic, clinical, consultative, administrative, and CI e*perience! List information in reverse c ronological order and include: Dates +itle ,rgani"ation name Address -upervisors name and telep one .o$ responsi$ilities/accomplis ments o Direct patient care responsi$ilities +ypes of patient/client and diagnoses/treatments +otal clinical ours o Indirect patient care responsi$ilities Administration /ducation 0esearc -pecial assignments/pro1ects
Date Tit"e Or(ani+ation Name Addre De cri/tion Direct Patient Care Indirect Patient Care !u/er0i or Name,Te"e/hone Tit"e Or(ani+ation Name Addre De cri/tion Direct Patient Care Indirect Patient

Date

Care !u/er0i or Name,Te"e/hone

PRO&E!!IONAL DEVELOPMENT1 Include professional development/continuing education completed! List information in reverse c ronological order: 2or)s op title / C/ title Date#s% Location #City, -tate% 3um$er of Continuing /ducation 4nits #C/4s% 5resenter -ponsor and address Lengt of presentation
Date2 3 CEU Tit"e Cit#4 !tate !/on or 5 Addre Pre enter Tit"e Cit#4 !tate !/on or 5 Addre Pre enter

Date2 3 CEU

&It is essential to maintain a permanent record of your C/ documentation! Documentation includes course title, description, o$1ectives, sc edule and certificate of completion!

TEACHING ACTIVITIE! COLLEGE , UNIVER!IT) COUR!E!1 Course +itle Date Location College/4niversity Lengt of presentation 3um$er of continuing education units/contact ours +opic, description 6 o$1ectives for all portions you presented
Cour e Tit"e Location Co""e(e,Uni0er it# Len(th o* Cour e To/ic 2i* di**erent *rom cour e tit"e3

Date Credit Hour

De cri/tion 5 O-6ecti0e Date Credit Hour Tit"e Location Co""e(e,Uni0er it# Len(th o* Cour e To/ic 2i* di**erent *rom cour e tit"e3 De cri/tion 5 O-6ecti0e

&'aintain separate records of involvement in student clinical education #names of students, dates of affiliation, level, and area of practice%

PO!T%GRADUATE CONTINUING EDUCATION1


Date CEU Contact Time 7ith Learner 11 Tit"e Location !/on or To/ic4 De cri/tion and O-6ecti0e Date CEU Contact Time 7ith Learner 11 Tit"e Location !/on or To/ic4 De cri/tion and O-6ecti0e

&It is essential to )eep a permanent record of your presentation#s%! Documentation includes all of t e a$ove plus summary of participant evaluations! &&Contact time is t e actual amount of time t at you are presenting and/or interacting (it t e learners!

CLINICAL IN!TRUCTION List roles/activities related to clinical education of 5+s and 5+As at all levels of education! Dates 0ole/position -ummari"ed data o 3um$er of students o Level of instruction o Duration of affiliation
Date Ro"e !ummari+ed Data 2#ear"# -a i 3

&'aintain separate records of involvement in student clinical education #names of students, dates of affiliation, level, and area of practice%

COMMUNIT)%BA!ED EDUCATION
Date Tit"e Location !/on or Len(th o* Pre entation De cri/tion Tit"e Location !/on or Len(th o* Pre entation De cri/tion

Date

!CHOLARL) ACTIVITIE! PRO&E!!IONAL PRE!ENTATION! Include platform or poster presentations at professional meetings and invited lectures ips suc as 'c'illan Lecture or 'aley Lecture: +itle of presentation Date Location Lengt of presentation 7rief description -ponsors
Date Tit"e Location !/on or Len(th o* Pre entation De cri/tion Tit"e Location !/on or Len(th o* Pre entation De cri/tion

Date

PUBLICATION! Aut ors ip of $oo) c apters, peer revie(ed 1ournal articles, researc a$stracts, revie(s or commentaries and case study or case study reports! o 4se A'A format for full $i$liograp ic reference

o A useful (e$site for A'A citation styles is: ttp:// ealt lin)s!(as ington!edu/ sl/styleguides/ama! tml -ample A'A format citation for .ournal Article: 3oonan V, Dean /: -u$ma*imal e*ercise testing: clinical application and interpretation! Phys Ther 8999 Aug:;9#;%:<;8-;9< 5rofessional activities related to sc olars ip includes grant proposals, (ritings you ave edited suc as $oo)s, peer revie(ed 1ournals, and su$missions to outcomes data$ase suc as =oo)ed on /vidence, and manuscript revie(s! List in reverse c ronological order: o 0ole #editor, revie(er, $oard mem$er, grant (riter% o +itle of (or) o Aut or #if applica$le% o 5u$lication date o 5rovide $i$liograp ic reference or $rief description of (or)

Ro"e Tit"e o* 8or9 Author Pu-"ication Date Bi-"io(ra/hic Re*erence,Brie* De cri/tion Ro"e Tit"e o* 8or9 Author Pu-"ication Date Bi-"io(ra/hic Re*erence,Brie* De cri/tion

RE!EARCH ACTIVITIE! List current researc pro1ects:


Tit"e De cri/tion Len(th o* Pro6ect Re /on i-i"it# 8ithin Pro6ect &undin( !ource Amount o* &undin( De cri/tion Len(th o* Pro6ect Re /on i-i"it# 8ithin Pro6ect &undin( !ource

Tit"e

Amount o* &undin(

PRO&E!!IONAL MEMBER!HIP 5 ACTIVITIE! List all professional or scientific societies t at you are a mem$er of! Include t e follo(ing: Dates Association or society name 'em$ers ip status Indicate if you eld a position in addition to $eing a mem$er and t e years you eld position 7rief description of accomplis ments
Date A ociation,!ociet# Mem-er hi/ !tatu Po ition ,O**ice He"d and Date Brie* De cri/tion o* Accom/"i hment A ociation,!ociet# Mem-er hi/ !tatu Po ition ,O**ice He"d and Date Brie* De cri/tion o* Accom/"i hment

Date

PRO&E!!IONAL !ERVICE! List committee mem$ers ip, association activities, content e*pert/consultant, or ot er profession related activities! Information listed s ould $e organi"ed in reverse c ronological order and include: Dates 5osition eld/title Committee name/organi"ation Description #$ulleted% o Accomplis ments
Date Tit"e,Po ition Committee Name,Or(ani+ation De cri/tion Accom/"i hment Tit"e,Po ition Committee Name,Or(ani+ation De cri/tion Accom/"i hment

Date

HONOR!,A8ARD! List onors and a(ards you ave received t roug out your educational and professional (or) e*periences! /*amples of t is may $e university deans list, professional or academic fraternities, and organi"ation recognition! Information to include is: -c ool/organi"ation $esto(ing onors/a(ards 7rief description of a(ard Date received
Date Recei0ed !choo" , Or(ani+ation De cri/tion o* Honor,A7ard !choo" , Or(ani+ation De cri/tion o* Honor,A7ard

Date Recei0ed

UNIQUE QUALIFICATIONS List any additional qualifications you possess that may compliment your professional knowledge and skills such as sign language, fluency in a foreign language, and advanced computer literacy.