Individual Membership Application Welcome to the International Association of ESD Professionals! Please complete this membership application to complete the process. Membership is subject to approval. If your membership application is declined, we will contact you with information as to the reason and refund your membership fee. If you believe that you were declined in error, you may submit an appeal in writing/ via email. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Applicant InformationFull Name *Phone NumberPersonal PronounsShe/ HerHe/ HimThey/ ThemOtherPronounsDate of Birth *Country of Residence *Where do you currently live?Email Address *Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryQualification DetailsESD Education *Date of Award *Awarding Institution *Transcript/Results *Would you like to add additional Qualification Details?YesNoESD Education 2 *Date of Award 2 *Awarding Institution 2 *Transcript/Results 2 *IAESDP Credentialing Exam *First timeCredential RenewalIs this the first time you are taking the exam or are you renewing your credentials?Is there any other information you would like to provide?Please add any other training and educational highlights that you feel are important for us to consider. ESD & Teaching ExperienceYears of experience teaching List the languages in which you teachDo you train/ certify/ offer a certification program for ESD Instructors?YesNoHow many Instructors have you trained?Are you an ESD Mentor?YesNoIf yes, what organization(s) do you provide mentorship through?Do you have Martial Arts or Physical Education Teaching Experience?Please list all of your relevant Martial Arts and Physical Education teaching experiences here.Other Education and MentorshipPlease list any other relevant teaching education and experience.Please indicate any military or law enforcement experience.Please indicate any Mental Health and Wellness education and experience.Evidence of Prior LearningDescription of Learning * indicate Vitae do Work Experience *Training Courses *Supporting DocumentsCurriculum Vitae * Click or drag a file to this area to upload. Please upload your complete resume. This resume should reflect all education, training, and experience that is relevant to the courses that you intend to host on The Idea Bridge.Certificates and Awards Click or drag a file to this area to upload. Upload copies of relevant certificates and awards.Background Check * Click or drag a file to this area to upload. If you are a US Resident, you must provide a copy of a Background Check no older than 30-days from the time of your application. You can obtain your background check here: https://www.backgroundreport.com/report/select for just under US$20.00.Membership OptionsPlease, select your Membership Tier below. Choose one: *Tier 1: (Annual Income: US$60,000 and above) - $200.00Tier 2: (Annual Income: US$40,000-60,000) - $160.00Tier 3: (Annual Income: US$20,000-40,000) - $120.00Tier 4: (Annual Income: US$10,000-20,000) - $80.00Tier 5: (Annual Income: US$5,000-10,000 - $50.00Tier 6: (Annual Income: Below US$5,000.00) - $30.00I am applying for Finacial Assistance. - $0.00Please select the pricing Tier that best applies to you. If you are applying for Financial Assistance through Scholarships or Sponsorships, you must complete the Financial Assistance portion of this form.Choose Renewal Option *Manual RenewalAutomatic RenewalStripe Credit Card *Financial Assistance RequestComplete ONLY if you are applying for Financial Assistance. All fields and uploads MUST be completed to process Financial Assistance Requests. If you do not require Financial Assistance, continue to the Agreements Section.Are you a Student?YesNoPart-timeCurrent Employer or Educational InstitutionList yourself if you are currently self-employed. Start and End DatesPlease upload any documents necessary to explain your Financial Situation, including proof of Income and Expenses Click or drag files to this area to upload. You can upload up to 4 files. Documentation may include paystubs, tax forms, letters from employer or instructors/ educational institutions (on organization letterhead), or a letter from you, on letterheard, certifying your income and expenses.AgreementsI certify the following: *I agree to abide by the IAESDP's Confidentiality PolicyI agree to abide by the IAESDP Code of EthicsI declare that the information I have provided in this application is true and correct to the best of my knowledge.You must check all three boxes.Signature Clear Signature How did you hear about the IAESDP and The Idea Bridge?Social MediaInternet SearchAssociation EventAssociation MemberESD Seminar/ Workshop/ EventColleague/ FriendESD Certificate ProgramSubmit Skip back to main navigation