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IPAT User Qualification Form

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IPAT User Qualification Form

IPAT psychological assessments are restricted to qualified purchasers. Thus, new customers need to complete the IPAT User Qualification form below, so we can verify your credentials.


 
First name * Last name * Job title
Organization
Address line 1 *
Address line 2
City * Zip / postal code *
Country * State
Telephone * Fax
Email *
Assessment applications (check all areas in which you use assessments)






Work setting (Select the organization type that best describes where you work)





Organization size





Number of assessments you administer per year






Number of courses / Professional development events you typically attend each year



Which track(s) are you applying for (Check all that apply)

1. Highest degree attained
Year
Degree
Major field
Institution
2. Course work completed in tests and measurements (Check all that apply)



3. Participation in IPAT - sponsored workshops
Course title Course date (MM/DD/YYYY)
4. Current membership in professional organizations (Check all that apply)





Other
Other
5. Professional experience/credential(Check all that apply)



6. Professional licenses and certificates relevant to assessment and testing
Certificate / license number
Title
Agency
State Expiration date (MM/DD/YYYY)
I agree that:
*
*
*
*
 
Please note that it may take up to 30 seconds for the form to submit. You will receive a response within one working day.