Apply to be a trainer

Failure to upload all required documentation will result in a delay in processing your application. Please make sure to upload all documentation in each section that documentation is required before submitting

Education and Experience

Highest Educational Level completed: *

Professional [Healthcare] License information (if applicable):

Other Tenure (Select all that apply)

Body Altering Aesthetics (BAA) Experience * (check all that apply)

1 year of professional experience in either licensed profession or approved other tenure I have completed more than 100 hours of study in my academia field; the courses I intend to submit are in my academia field I have public speaking or teaching experience I am able to pass a background check

Background Check

These questions must be answered by the Individual Advanced Scholastic Trainer. It is the responsibility of the Advanced Scholastic Trainer to ensure that the answers to these questions are accurate, true and correct. In an effort to better serve the public trust, ACBAA reserves the right to conduct and/or review a criminal history background check and to deny an application and/or sanction an Advanced Scholastic Trainer’s status based on the commission of a crime. Such denials or sanctions shall be determined on a case-by-case basis.

Answers to the following questions are mandatory. Failure to respond to each question may result in the application being denied. Failure to provide accurate, true and correct information in answering these questions shall constitute grounds for denial of your application and/or sanctions rendered to your Advanced Scholastic Trainer status.

If all of the appropriate information is not provided, the processing of your application may be delayed, and your application will be considered incomplete. All information submitted in accordance with these questions shall remain confidential, except that it may be disclosed to CSL staff and legal counsel for processing and to law enforcement agencies, and any country, state, county and/or local governmental agencies as needed.

Have you ever been convicted of, or entered a plea of guilty, nolo contender, or no contest to, a crime in any jurisdiction other than a minor traffic offense?

Yes No

Pending Criminal Case (Individual): Do you currently have a pending criminal case against you?

Yes No

Professional Conduct

Is there currently pending, or has there ever been, a complaint made against your professional conduct or competence in any; country, state, county or local jurisdiction?

Yes No

Has a sanction been imposed on you, your practice, or your organization by a licensing or credentialing body? (A sanction is the imposition of a penalty based on the violation of procedures, policy, etc.)

Yes No

Professional Liability Insurance

Do you as an individual have professional liability insurance or does your organization provide its instructors with liability insurance?

Yes No

State/Jurisdiction Compliance

Are you and/or your organization in compliance with all of the rules and regulations within your state/jurisdiction?

Yes No

Terms of Service

Statement of Compliance with the Americans with Disabilities Act (ADA) and Title VII of the Civil Rights Act (CRA)

By checking the box below, you agree to meet the requirements of both of these acts of congress. For more information on these acts, please visit the ADA and Title VII sites.

Are you and/or your organization in compliance with all of the rules and regulations within your state/jurisdiction?

As a provider of continuing education, I agree to comply with the ADA and Title VII of the CRA

Trainers to other regulatory boards: Have you ever before or are you currently an approved trainer for any other regulatory board (if yes, list)

Have you previously taught any industry classes? *

Yes No

How were you introduced to this industry?

Why do you want to be a trainer?

Tell me about a difficult patient experience and how you handled it.

How would you handle an unruly registrant or unhappy attendee to one of your classes?

Name one thing the industry needs or is missing from the industry

What type of courses are you interested in offering?

Administrative Processes

Read the statements below and indicate with a check mark that you will comply per CSL guidelines. Registration, Cancellation, and Refund Terms of Service

I understand that it is required that my policies clearly state how participants register for my courses. I understand that it is required that my policies clearly state registration deadlines. I understand that it is required that my policies clearly state cancellation policies. I understand that it is required that my policies clearly state my refund policy

Agreement to Report Changes

l agree to report any changes in my answers

Who was your Recruiter?

If your recruiter was someone else, type their name below

Final Acceptance

Please check the box below to indicate your agreement to report any changes in your answers to the above questions to ACBAA via writing or email at welcome@CSLtherapy.org.

American Council of Body Altering Aesthetics Advanced Scholastic Trainer Application

PROVIDER INFORMATION

Education and Experience

Background Check

Professional Conduct

Sanction

Professional Liability Insurance

State/Jurisdiction Compliance

Terms of Service

Training Experience

Interview Questions

Administrative Processes

Agreement to Report Changes