Certification Application

IBOSP Certification Application

Thank you for choosing to be a part of the most contemporary and inclusive group of sexuality professionals worldwide. We ask that you are transparent and fill out the below form to the best of your ability. Our team of application specialists will verify all collected data to award you with your certification and acceptance into the International Board of Sexuality Professionals.

Name

Address

City

State

Zip

Telephone

Format: (000) 000-0000.

Email

example@example.com

Please read instructions carefully, and include all required documentation.

1. Complete all pages of the application.

2. Applicant's signature must appear as designated on the various pages of the application.

3. Applicants must ensure submission of endorsement forms, transcripts and other relevant supporting materials accompany this application. Applicants must also include a copy of all their supervision contract(s) along with all of the supporting documents.

4. The non-refundable application fee of $100.00 is required before the review process begins. Once your application has been submitted, instructions for online payment will be emailed to you.

5. It is preferred that complete applications with all supporting documentation be filled out online or be emailed to certification@ibosp.org. If email is not an option, please contact us for additional options. It is recommended that you keep a copy of the complete application for your records.

Please include documentation of IBOSP membership

By signing this application, you confirm that you have read the IBOSP Code of Ethics and agree to be bound by them. You acknowledge that all of the documentation within this application was acquired by or otherwise pertains to you.

I. Your Signature

II. Which certification are you applying for

III. Academic and Professional Experience Please list your earned academic degrees below.

All academic degrees earned were from an accredited institution. If not, please explain:

Attach a transcript of your highest earned academic degree. (Minimum of Master's degree)Please attach your curriculum vitae or resume.

Please attach your curriculum vitae or resume

Current position

Business name and address

Social media (Instagram, Facebook, Linkedln, TikTok, etc.)

Publications / Papers

We would like to know if you have been published or if you have written any papers. As an IBOSP member, we would like to promote any books or media you are proud about.

Publication Name #1 and Link to Publication #1

Publication Name #2 and Link to Publication #2

Publication Name #3 and Link to Publication #3

Dissertation Title:

Link to Dissertation:

IV. Clinical Certification & Licensure

Attach a copy of your valid state regulatory license or certificate if you have one.

Please attach documentation of meeting requirements for the certification you are applying for.

Attach endorsement letters here

My Products

Application Fee

$100.00 Quantity

Total

$0.00

Acknowledgement and Signature

I hereby apply for certification by the International Board of Sexuality Professionals and certify that the statements contained in this application and its attached documents (if any) are true to the best of my knowledge and belief and further acknowledge that falsification is cause for disqualification or future revocation of any certification granted. I hereby grant permission to the Board to make any inquiries it deems necessary to confirm these statements and to determine the quality of my practice. I further understand and agree that in consideration of my application, my professional standing will be reviewed and assessed by the Board; that the Board may make inquiry of the persons and institutions named in my application and of such other persons as the Board deems appropriate with respect thereto; but that I will not be advised of the identity of the persons from whom information has been requested or as to the nature of such information; and that all statements and other information furnished to the Board in connection with such inquiry shall be confidential and not subject to examination by me or by anyone acting on my behalf. And Ihereby agree that if my application is not acted upon favorably, I will in no way seek to hold the Board or any of its officers legally responsible for such action.

Signature

Date