IAED Certification Registration

IAED Certification Registration
APPLICATION AND QUESTIONNAIRE
Date of Certification

MonthDayYear
Date
Location of Certification
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
IAED Candidate Requirement Policy

A.  Candidates must be a graduate of a formal equine dental education program with at least 240 hours of education

B.  Candidates that have attended a Veterinary School must have 80 hours designated to equine dental education

C.  Recommendation to have a signature of an IAED Certified Member who will testify to the candidate's ability (OPTIONAL)
SCHOOL ATTENDED
DATES OF ATTENDANCE
GRADUATION DATE:

MonthDayYear
Date
IAED Certification General Policy

A. To be a candidate for IAED Certification you must be a IAED member in good standing

B. The IAED Certification Candidate must not have a pending grievance

C. IAED Certification Candidates must meet all prerequisite requirements
I am a member of the IAED in good standing

YESNO
Detail
I meet all the prerequisite requirements

YESNO
Details
I understand that I must successfully complete and IAED written examination prior to attempting the IAED practical examination.

YESNO
Details
E. IAED Certification will require that candidates successfully complete an IAED Practical Examination as set out by the IAED Board
I understand that I must successfully complete and IAED written examination prior to attempting the IAED practical examination.

YESNO
E. Both the written and practical parts of the IAED Certification Examination must be passed by 80% or better to receive IAED Certification
I understand that I must pass the written and practical parts of the IAED Certification Examinations by 80% to receive IAED Certification

YESNO
I attest all my answers are correct and true at the time of signing this document.

YESNO
SIGNATURE

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MonthDayYear
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You must be a member to sit for Certification
Are you a Current Member of the IAED*

YesNo
My Products
prevnext( X )
Certification -$750.00

Membership (Must be a current member) -$225.00

Student Membership (Must be a current member) -$150.00

Hands-On Workshop/Dental Clinic - Participant Cost$275.00

Workshop Dental Clinic - Auditor Attendance$75.00

Certification Registration Only$ Free
This option is for a student registering for Certification but not paying at this time. Student will need to come back to this form and make online payment before being eligible for Certification testing.

Total $0.00
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IAED Certification Registration

APPLICATION AND QUESTIONNAIRE