Please fill out the form below. Fields marked with an asterisk* are required.

Please note: This is the Colorado version of EASy. If you are applying in another state, please be sure to select that state from the drop-down below.

Please use a personal email address (yahoo, gmail, etc.) as many agency email servers block emails from EASy.

Education (check one or more)*

Work Experience(s) with/related to infants, toddlers and their families*

Total number of years paid work experience with or on behalf of infants/toddlers and/or their families:

Reflective supervision/consultation:



You may attach a resume or curriculum vitae. This is recommended if you have more than 3 relevant paid work experiences.

File should be in .PDF, .DOC, .DOCX or .RTF format



You must join or renew membership to COAIMH when submitting this preliminary application.

Endorsement Category*

Please review and verify all data before submitting!