Registration for Certification Form

  • Member Information

  • Date Format: MM slash DD slash YYYY
  • Employer Information

    Complete only if changed from Application for Intermediate Certification.
  • Education Information

    Complete only if changed from Membership Application.
  • Date Format: MM slash DD slash YYYY
  • Previous Child and Youth Care Experience

  • Candidates Acknowledgement

    I attest that the information provided is true and complete to the best of my knowledge. I understand that misrepresentation could result in decertification by The Child and Youth Care Association of Alberta.
  • Drop files here or
    Please upload a signed copy(ies) of the "Endorsement of Supervisor and Agency for Certification Maintenance" document and your CYC Education credentials (if applicable).
  • Price: $ 90.00 CAD

Please ensure that you have met the requirements for registration for certification:

  • Current membership on file
  • CYC Education only, copy of Diploma or Degree enclosed
  • Endorsement of supervisor and / or agency enclosed
  • Registration fee $90.00 payment or receipt enclosed.

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 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 cycaa@telus.net.