CSD Additional Information Request

Current Credentials

Please select the credential(s) that you currently hold and enter the certification or certificate number(s).

Employment Information

Previous Employer (if current job does not meet the minimum professional safety experience as indicated on the CSD Track). If you begin this section, please complete all fields and include Supervisor Name and Supervisor Email.

Previous Employer (if current job does not meet the minimum professional safety experience as indicated on the CSD Track). If you begin this section, please complete all fields and include Supervisor Name and Supervisor Email.

The NASP/IASP, Inc. Certification Board (NASPCB) has the right to evaluate the character of applicants, candidates, and Certificants of the NASP/IASP, Inc. Certification Program. The NASPCB considers criminal conviction history and known unethical behaviors of each applicant, candidate, and Certificant of the NASP/IASP, Inc. Certification Program. If you answer “Yes” to #1, please fill out and upload the Criminal Convictions and Unethical Behavior Form. Click here for a copy of the form.

Your signature below gives consent to the NASPCB to verify all information provided in this form to include but not limited to the stated education (diploma and transcripts or academic record(s) showing degree/s earned and date granted), credential(s) held, employment history, and criminal conviction history and known unethical behaviors. Your signature also indicates you agree to the Code of Ethics and Non-Disclosure Agreement found at the bottom of this page. By typing your name, this serves as your electronic signature. You agree your electronic signature is the legal equivalent of your manual signature on this application.

Click or drag files to this area to upload. You can upload up to 30 files.

*Please upload the supporting document/s showing that you currently hold the certification/s as indicated.

Please upload a copy of an official diploma and official transcript or academic record(s) showing degree earned and date granted for High School or Higher Education. The NASPCB will accept a copy of an official transcript. Non-U.S. degree holders are required to have their academic records evaluated for U.S. equivalency. Documents that are not issued in English must be accompanied by an official or certified English translation.

 

The NASPCB will need to verify your official diploma and official transcript or academic record(s). In addition to uploading these documents, please request your academic provider/verifier (High School and/or Higher Education) to send verification directly to the NASPCB Attn: Teresa Amey NASPCB Certification Coordinator at [email protected]. If your academic provider (High School and/or Higher Education) directly permits third parties to verify the official diploma and official transcript or academic record(s), please email [email protected] and provide the contact information.