Demande d'examen d'accréditation - Association of ESD Professionals

Nom

First

Last

Adresse électronique

Numéro de téléphone

Please include country code

Pays de résidence

Adresse

Ligne d'adresse 1

Ligne d'adresse 2

Ville

État / Province / Région

Code postal

Pays

I am applying for the following Exam period

PERIOD ONE (Janvier, Février, Mars)
PERIOD TWO (Avril, Mai, Juin)
PERIOD THREE (Juillet, Août, Septembre)
PERIOD FOUR (Octobre, Novembre, Décembre)

See the Credentialing Pages on our website for dates of the next exam period. https://esdprofessionals.org/exam/

I would like to take the exam in the following format:

All at once: Must take all 5 modules in the same session
Separate modules: Can take one module at a time over several days/sessions in any order

For both options: Once you begin the exam (option 1) or a module (option 2), it cannot be restarted. Should you exit out, close the browser, or fail to complete the exam or module, the Association cannot guarantee your responses will be saved or that the Exam can be validated.

ESD TRAINING & EDUCATION

Where did you learn to teach ESD and describe the nature of your training.

When did you get your ESD training?

Approximately how many hours of ESD training have you completed?

Are you currently being mentored by an ESD Professional in any capacity?

Oui
Non

ESD TEACHING EXPERIENCE

How many years have you taught ESD?

Approximately how many hours PER YEAR do you teach?

List the languages in which you teach ESD

What is the nature of your ESD teaching?

I teach as an employee or founder of an ESD-focused non-profit or NGO
I teach as a volunteer with an ESD-focused non-profit or NGO
I teach as an employee or owner of an ESD-focused business with two or more employees
I am an independent instructor (I teach solo or with occasional assistants)

Do you train ESD Instructors?

I teach students only
I teach students and train instructors
I only train instructors

Please only indicate personalized group or one-on-one instructor training, not pre-recorded virtual and online courses.

Combien d'instructeurs avez-vous formés ?

Please do not count pre-recorded virtual courses but rather individuals you have worked with personally.

What organization(s) do you provide training through and what is the nature of the instructor training?

Please do not count pre-recorded virtual courses but rather individuals you have worked with personally.

Have you ever mentored other ESD Instructors?

Oui
Non

How many Instructors have you mentored?

What organization do you provide mentorship through and what is the nature of the mentorship?

OTHER EDUCATION

Do you have martial arts, krav maga, or other forms of self-defense teaching experience? Please describe.

Do you have any mental health, wellness, or physical fitness education or experience? Please describe.

Examples: Degree in social work or psychology, yoga teacher training, personal trainer work, etc.

Please describe any other relevant education, experiences, teaching, and trainings.

Examples: University or primary school teaching, first aid certification, performance or public speaking experience, etc.

SUPPORTING DOCUMENTS

Background Check for United States Applicants

If you don't have a recent background check dated no more than 6 months ago, please conduct a background check on yourself. (This way we do not have to collect your social security number). Go to this website: BackgroundReport.com and choose the "Check Yourself" option. Select "Basic" $21.95.

Direct link: https://www.backgroundreport.com/self

We are asking for this because a background check is a requirement in order to partner with certain organizations and get insurance pricing breaks. If you have any questions or concerns about this, please contact us. credentials@esdprofessionals.org

Please email us the background check as soon as it is done if you don't yet have one to attach to this application. Email to: credentials@esdprofessionals.org

Background Check Document

Cliquez sur un fichier ou faites-le glisser dans cette zone pour le télécharger.

Please upload your background check, dated no more than 2 years ago.

Curriculum Vitae

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Please upload your CV or resume. It may include your work experience, education, achievements, and skills. This will not be public. Files should be under 10 MB.

ESD Biography (public)

Please include a biography written in third person that we can share publicly. Please keep the biography under 250 words. Your biography could include your name, occupation, achievements, ESD training, and country. By filling out this field, you are agreeing to the public use of your biography for Association announcements.

Headshot (public)

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Please upload a headshot we can share publicly. Please ensure the photograph is a front-facing view and includes your face. By uploading a headshot, you are agreeing to the public use of your headshot for Association announcements. Photos should be under 10 MB.

MEMBERSHIP

Are you a member of the Association of ESD Professionals?

I am a current member
My organization is a member
I am not a member

EXAM COST & FINANCIAL ASSISTANCE

Standard Pricing: I can pay the full $300 USD Member / $400 USD Non-Member rate for the exam

Oui
Non

Financial assistance is available if "No" is selected.

FINANCIAL ASSISTANCE

The Association will consider your country of residence when making determinations for test pricing. We can also reduce rates based on self-identified need.

View tiered pricing examples on our credentialing FAQ: https://esdprofessionals.org/exam/

What price do you feel you could pay for the exam?

These are the reasons I request financial assistance:

TESTING ACCOMMODATIONS

I would like to request any kind of accommodation for taking the exam

Oui
Non

Examples: Issues related to vision, test anxiety, internet access, access to a computer in a private setting, language, etc.

What accommodation(s) are you asking for?

Please explain why you are requesting this accommodation?

RECOMMENDATIONS

PLEASE REACH OUT TO TWO (2) INDIVIDUALS TO PROVIDE REFERENCES

Send the following link to your references so they can submit directly to the Association. You can assure them the form is short and quick, and will take less time than writing a recommendation letter.

LINK TO RECOMMENDATION FORM

(It will open in a new window)

Note that we are seeking recommendations from individuals who can provide you a character reference. Therefore, you are not limited to the ESD world for references. Individuals who could provide character references include: ESD colleagues, mentors, trainers, co-instructors, or students; AND colleagues, supervisors, clients, mentors, or mentees in any other field. Please just ensure they are over 18 and not someone you have a direct familial or romantic relationship with (such as a spouse or long-term partner, parent, sibling, or child).

You cannot be confirmed to take the exam without both your recommendations, so please encourage them to fill out the form ASAP.

Names of My References

Please provide us with the names of the individuals who will be sending recommendations, if you already know. If you don't yet know both names of who you will be asking, that's fine, fill out one name or none.

AGREEMENTS

CODE OF ETHICS

READ THE ASSOCIATION CODE OF ETHICS HERE

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Ethics Code Acknowledgement

I acknowledge that I have read and understand the Association Code of Ethics and agree to abide by it and all its terms and provisions.

CONFIDENTIALITY POLICY

READ THE ASSOCIATION EXAM CONFIDENTIALITY POLICY HERE

(It will open in a new window)

It is critical to the integrity of the exam and the Association Credential Program that the exam and all its contents remain confidential. Therefore, the Association has created a policy whereby all exam candidates sign a statement declaring that they have read and understood the Exam Confidentiality Policy and that they agree to abide by it.

By signing below, I acknowledge that I have read and understand the Association Exam Confidentiality Policy and agree to abide by it and all of its terms and provisions. I further agree not to participate in any conduct identified as cheating before, during, or after exam administration and acknowledge that penalties for violating the Exam Confidentiality Policy may result in review by an Association Review Panel.

teach many ACCOMMODATIONS

Signature

Signature claire

GDPR Agreement

I consent to having this website store my submitted information so they can respond to my inquiry.

I declare that the information provided in this application is true and accurate to the best of my knowledge and that the documents submitted in support of this application are genuine. I understand that any dishonesty will be grounds for considering denial of this application.

Signature

Signature claire

Newsletter Sign Up

I agree to receive newsletters and updates from the Association of ESD Professionals
I do not want to receive newsletters and updates from the Association of ESD Professionals

How did you hear about the credentialing program?

If Other was selected, please describe