Credentialing Exam Application - International Association of ESD Professionals

Name

First

Last

Email Address

Phone Number

Please include country code

Country of Residence

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

I am applying for the following Exam period

PERIOD ONE (January, February, March)
PERIOD TWO (April, May, June)
PERIOD THREE (July, August, September)
PERIOD FOUR (October, November, December)

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

Yes
No

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.

How many Instructors have you trained?

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?

Yes
No

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 to get insurance pricing breaks. If you have any questions or concerns about this, please contact us at 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

Click or drag a file to this area to upload.

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

Curriculum Vitae

Click or drag a file to this area to upload.

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.

0 of 250 max words.

Headshot (public)

Click or drag a file to this area to upload.

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 Individual Member
My organization is a member and I'm one of 3 representatives
My organization is a member and I'm a staff member
I am not a member

Membership ID

Please enter your Membership ID number for verification.

EXAM COST & FINANCIAL ASSISTANCE

The IAESDP is happy to provide Financial Assistance to applying Members and Exam Candidates to cover the cost of the Exam. We provide financial assistance in the form of limited duration Sponsorships and Scholarships.

All applications received are weighed equitably and inclusively, applying Empowerment Self Defense Principles to the best of our ability. If you have any questions about the process, please contact us at info@esdprofessionals.org.

Non-Member Exam Pricing Tiers

The Association offers international tiered pricing and discounted pricing for those requiring financial assistance. Individual Members of the Association receive an 20% discount on Credentialing Exam pricing as listed above. If your organization is a member of the Association, 3 Organization Representatives will receive a 25% discount of the pricing above, and staff (not representatives) receive a 15% discount.

Have you been affected by the defunding of USAID and you live outside of the United States?

Yes
Not Sure
No / Not Applicable (US Resident)

We understand that instructors in countries outside of the United States have been affected by the freezing of funds to USAID programs. If you have been directly affected, you are eligible for a scholarship for the Credential Exam.

Briefly describe how you have been affected by the defunding of USAID.

Do you want to be considered for a full scholarship to take the exam with no cost to you?

Yes, I want to be considered for the scholarship
No, I can afford to pay for the exam

If you marked "Yes", please fill out the Financial Assistance portion of the application below. If you marked "No", you may still be eligible for reduced cost exam fees. Fill out the Financial Assistance portion as needed.

FINANCIAL ASSISTANCE

Please complete the following section to the best of your ability. The Proof of Income/Expenses uploads can be as simple as a letter, on letterhead, explaining your financial need. Please use US Dollars in your responses.

Current Employer

Start and End Dates

Examples: 10/2019-1/2024; 10/2019-current

Annual Income in US Dollars

Amount I Could Pay for the Exam (US Dollars)

These are the reasons I request financial assistance:

Please upload proof of income and expenses

Click or drag a file to this area to upload.

This upload can be tax documents, paystubs, or as simple as a letter, on letterhead, explaining your financial need.

TESTING ACCOMMODATIONS

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

Yes
No

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

(It will open in a new window)

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.

Signature

Clear Signature

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

Clear Signature

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

ESD TRAINING & EDUCATION

ESD TEACHING EXPERIENCE

OTHER EDUCATION

SUPPORTING DOCUMENTS

Background Check for United States Applicants

MEMBERSHIP

EXAM COST & FINANCIAL ASSISTANCE

FINANCIAL ASSISTANCE

TESTING ACCOMMODATIONS

RECOMMENDATIONS

AGREEMENTS

CODE OF ETHICS

CONFIDENTIALITY POLICY

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