FACILITATOR CERTIFICATION ACCREDITATION

FACILITATOR CERTIFICATION ACCREDITATION/TRAINING ACCREDITATION

Please complete and submit Parts 1-4 to INIFAC as part of your application for Facilitator Certification Accreditation/Training Accreditation. *Once this form has been submitted an invoice will be sent to you for payment.
PART 1. APPLICANT INFORMATION
Name of Organization
Contact Person
Contact’s Title
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
Certification or Training Course Name

Part 2. CERTIFICATION INFORMATION

Please provide us with the following information.
1. Description of training course or certification (250 word limit)

0/250

2. Statement of qualification. *After receiving your training or certification, what will the candidate be able to say they are capable of?

3. What assessment methods or documents do you incorporate into your program. *For example, questionnaire, video role plays, references, level of experience.

Written or Verbal AssessmentVideo/Shadowing AssessmentExample of an agendaShadowing another certified personOther

4. What are the requirements for your training or certification? *Please add any qualitative scoring number the candidate must achieve to be certified. For example, a score of 3 out of 5 on written assessment,3 letters of reference, 5 years of experience.

	SCORE
Written or Verbal Assessment
Video/ Shadowing Assessment
Example of an Agenda
References
Years of Experience
Other

Part 4. DOCUMENTATION REQUIRED

Please provide the following information as part of your application package.
- Your company’s certification application.
- A copy of your assessment rubric. Note: this is in addition to the information provided herein.
- Forms you require from your candidates.
- Instructions given to your candidate as part of the application process.
Upload here

Cancelof

My Products

Certification Accreditation

$2,500.00 Quantity

Training Accreditation

$2,500.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

FACILITATOR CERTIFICATION ACCREDITATION/TRAINING ACCREDITATION

PART 1. APPLICANT INFORMATION

Part 2. CERTIFICATION INFORMATION