Register of Exercise Professionals (REPs) Application for Level 4 Registration Specialist Fitness Instructor - Supporting Evidence

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1 Register of Exercise Professionals (REPs) Application for Level 4 Registration Specialist Fitness Instructor - Supporting Evidence Specialist Fitness Instructors at Level 4 on the Register of Exercise Professionals (REPs) must show that they have gained the skills and knowledge contained in one or more of the Level 4 National Occupational Standards. Level 4 status can be achieved in the following areas: Cardiac Disease, Falls, Stroke, Mental Health, Back Pain, Obesity/Diabetes. The normal route to achieving Level 4 status is by achieving an approved award or qualification in one of the REPs Level 4 medical areas. This form is to be completed ONLY by individuals who have full REPs status at Level 3 and the other Level 4 pre-requisites but do not hold a REPs recognised Level 4 award or qualification. This form gives you the opportunity to demonstrate your knowledge, competence and skills to gain acceptance at Level 4 in one of the above mentioned specialist medical areas where you have a proven track record. Personal Details From: Registration Number: The Registrar Register of Exercise Professionals 3 rd Floor 8-10 Crown Hill Croydon CR0 1RZ Current Status Level: Level 4 Criteria Full level status Level 3 Advanced Fitness Instructor Yes/No Level 3 context e.g. Older Adults; PT; Ante/Post Natal please state 1200 hours appropriate professional experience designing, delivering, monitoring and evaluating relevant physical activity to patients/clients in your area of specialism(reflected in CV or letter of reference) Yes/No REPs/Skills Active - Level 4 Panel Mapping Form Page 1

2 Completion of Professional Practice Unit (available online) Yes/No - if Yes state date of completion Level 4 Specialist area you are applying for (from). Cardiac Disease; Back Pain; Mental Health; Stroke; Falls; Obesity and Diabetes Use only the National Occupational Standard for the specialist area you are applying for. If you are applying for more than one area please complete this form for each additional area. Your application will be reviewed against the Level 4 National Occupational Standards (attached) for the specific medical area. Therefore you must explain how your qualification and experience meets these standards. Please complete the application form and ensure that the detail you give is specific to the relevant national standard for the medical area. The level of detail you give (together with supporting documentation) will assist the Level 4 Application Approval Panel to come to a decision on your application. Briefly outline your experience in the last 2 years of exercise programming and prescription within this specialist area stating approximate hours per week. REPs/Skills Active - Level 4 Panel Mapping Form Page 2

3 Please list the qualifications that you hold highlighting those which you feel are at an equivalent level to a Level 4 unit. Give a brief outline of the course length, the content, the assessment process and awarding body. Please attach a copy of your syllabus (if available). REPs/Skills Active - Level 4 Panel Mapping Form Page 3

4 Please comment in the boxes below on how the content of your qualifications relate to the components identified in the attached National Occupational Standards against the specific Level 4 standard that you wish to gain access to Level 4 against. Notes: Element 1: Design and agree a physical activity programme for patients/clients from the specific medical area Element 2: Deliver, review and adapt a physical activity programme for patients/clients from the specific medical area The detail for these Elements can be found in the Standards in the What you must do and What you must cover sections. Skills Knowledge The detailed knowledge for the Standard can be found at the back of the relevant unit If necessary please continue using another sheet Applicants signature: Date: REPs/Skills Active - Level 4 Panel Mapping Form Page 4

5 Professional Reference You must obtain a reference to support your application the referee should justify that this person has been designing exercise programmes for clients from the relevant medical area Name of referee Position and organisation Signature and date Contact /or telephone number: REPs/Skills Active - Level 4 Panel Mapping Form Page 5