INIFAC Certification Forms

1
What certification are you applying for?* This field is required.
Certified Master Facilitator®
Certified Competent Facilitator®
Certified Skilled Facilitator®
Certified Learning Facilitator®
Certified Master Learning Facilitator®
Certified Advanced Virtual Facilitator®
Certified Virtual Facilitator®
2
Are you a CMF®, CSF®, or CCF®?
Yes
No
3
Name* This field is required.
First Name
Last Name
4
Date
Date
Month
Day
Year
5
Phone Number* This field is required.
Please enter a valid phone number.
6
Email* This field is required.
example@example.com
7
Organization
8
Address* This field is required.
Street Address
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
9
Select Your Time Zone* This field is required.
10
Country* This field is required.
11
Provide three date and time options within the next three months for your 30-minute online assessment.* This field is required.
Date
Month
Day
Year
12
Time* This field is required.
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Minutes
AM
AM
PM
13
Date* This field is required.
Date
Month
Day
Year
14
Time* This field is required.
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Minutes
AM
AM
PM
15
Date* This field is required.
Date
Month
Day
Year
16
Time* This field is required.
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Minutes
AM
AM
PM
17
Website
18
Do you hold any INIFAC certifications?
Certified Master Facilitator®
Certified Master Learning Facilitator®
Certified Competent Facilitator®
Certified Skilled Facilitator®
Certified Learning Facilitator®
Certified Advanced Virtual Facilitator®
Certified Virtual Facilitator®
19
Are You a Certified Professional Facilitator?
Yes
No
20
Certificate Date
Date
Month
Day
Year
21
Do you hold any other professional facilitation certifications?
Yes
No
22
If yes, please enter the details
23
Upload Photo (Upload a Head Shot you would like us to use on the website for your certification)* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Browse Files
Cancelof
24
Upload Bio to be displayed on INIFAC website* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Browse Files
Cancelof
25
Country / State / Province of your residence
26
Number of years as a professional facilitator
27
Highest level of formal education
28
Formal facilitator training classes taken
29
Specific facilitation methods you employ
30
Other professional fields in which you have worked
31
Professional organizations of which you are a member
32
Gender
Male
Female
Other
33
Languages used in facilitating
34
How did you hear about INIFAC?
35
Products* This field is required.
prevnext( X )
My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Certified Master Facilitator®
Assessment fee for Certified Master Facilitator® without a nomination.
$2,350.00Edit
Back
0
0
1
2
3
4
5
6
7
8
9
10
Quantity
Certified Master Facilitator® with Nomination
Assessment fee for Certified Master Facilitator® with a nomination.
$2,150.00Edit
Back
0
0
1
2
3
4
5
6
7
8
9
10
Quantity
Certified Competent Facilitator®
Assessment fee for Certified Competent Facilitator®.
$1,000.00Edit
Back
0
0
1
2
3
4
5
6
7
8
9
10
Quantity
Certified Skilled Facilitator®
Assessment fee for Certified Skilled Facilitator®.
$1,000.00Edit
Back
0
0
1
2
3
4
5
6
7
8
9
10
Quantity
CCF®/CSF® to Certified Master Facilitator®
Assessment fee for current CCF®/CSF® who are applying for Certified Master Facilitator®.
$1,350.00Edit
Back
0
0
1
2
3
4
5
6
7
8
9
10
Quantity
Certified Master Learning Facilitator®
Assessment fee for Certified Master Learning Facilitator®.
$2,350.00Edit
Back
0
0
1
2
3
4
5
6
7
8
9
10
Quantity
Certified Master Learning Facilitator® with Nomination
Assessment fee for Certified Master Learning Facilitator® with nomination.
$2,150.00Edit
Back
0
0
1
2
3
4
5
6
7
8
9
10
Quantity
Certified Learning Facilitator®
Assessment fee for Certified Learning Facilitator®.
$1,000.00Edit
Back
Certified Advanced Virtual Facilitator®
Assessment fee for Certified Advanced Virtual Facilitator®.
$1,000.00Edit
Back
0
0
1
2
3
4
5
6
7
8
9
10
Quantity
Certified Virtual Facilitator ®
Assessment fee for Certified Virtual Facilitator®.
$198.00Edit
Back
0
0
1
2
3
4
5
6
7
8
9
10
Quantity
Total cost $0.00
First Name
Last Name
Should be Empty: