Application for Intermediate Certification

Please ensure that you have met the requirements for Intermediate Certification and have all documents needed before starting this application:

  • Review the Certification Process information page for changes to the process.
  • Current membership on file.
  • Completed Registration for Certification on file.
  • An Endorsement of Supervisor(s) is required to be uploaded with this application.
  • Intermediate certification date (Please note: minimally 30 days’ notice of exam date needs to be given)
  • A registration fee of $100.00 is required.

Please note: All fields marked with an * are required to complete the form.


Personal Information Protection

The information requested in this form is collected under the Personal Information Protection Act for Child and Youth Care Association of Alberta’s internal use only.  No information contained in this form will be disclosed to any other individual, group, or agency as per the Confidentiality Policy of the Child and Youth Care Association of Alberta.  Questions concerning this collection should be directed to