This document is the official application form for the Association for Integrative Psychology (AIP) Approved Institute certification. It collects applicant information (personal or business name, address, contact details), includes a legal indemnification clause, and allows the applicant to select certification types (Neuro Linguistic Programming, Hypnosis/Hypnotherapy, Time Empowerment®, MER®). The form outlines required supporting documents (trainer’s training completion certificate, course outlines, written tests), specifies fees for digital and physical certificates, and details shipping costs for physical certificates. Payment options are provided (credit card, PayPal/e‑invoice, or check) with associated instructions and a billing signature section. Submission directions include mailing address, fax number, phone contacts, and an email address. A revision note indicates the form version (Rev 02/13/24).

Topics

Application Form Overview and Applicant Information Capture

Structure of the form, fields for personal or business name, address, phone, email, and website.

Legal Indemnification Clause

Statement where the applicant agrees to indemnify AIP and its affiliates against claims, except for gross negligence or willful misconduct.

Certification Options Selection

Checkboxes for choosing which Approved Institute certifications the applicant seeks (NLP, Hypnosis/Hypnotherapy, Time Empowerment®, MER®).

Required Supporting Documentation

List of mandatory attachments: trainer’s training completion certificate, course outlines with standards, and written tests with answers.

Fee Structure for Digital and Physical Certificates

Pricing details: $125 per digital certificate (1‑year validity), $10 for each physical or replacement certificate, plus shipping fees.

Shipping Options and Costs

Checkboxes for selecting mailing method and associated cost ($3 US First Class, $5 Canada, $7 other countries).

Payment Methods and Billing Instructions

Options to pay via credit card, PayPal/e‑invoice, or check, including fields for card details, billing address, signature, and amount.

Submission Contact Details and Instructions

Mailing address, fax number, phone numbers, email, and note about a $25 returned‑check fee.

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