Certified Member Application Form

Please fill out the below form to provide us with the necessary information to complete your evaluation.

A member of the Evaluation Committee will reach out when they’ve had a chance to review your application or if they require more information.

Fields marked with an asterisk (*) must are required.

Certified Member Evaluation Request Form - English
Name
Name
First Name
Last Name
Address
Address
City
State/Province
Zip/Postal
Country
I want to be evaluated for certification through the following method:
Where was your training completed?

Canadian Training

Are you a recent graduate within the last 12 months?

Maximum file size: 4MB

Maximum file size: 4MB

Maximum file size: 4MB

International Training

Are you a recent graduate within the last 12 months?
Name of Faculty or Supervisor
Name of Faculty or Supervisor
First Name
Last Name

Maximum file size: 4MB

Maximum file size: 4MB

Maximum file size: 4MB

Work Experience Option

Maximum file size: 4MB

Maximum file size: 4MB

Checkboxes
What do you hope to gain by joining ACCP-CAID?
How did you hear about us?