Registration


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

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


Endorsement Category*

Please note:

Before completing the remainder of the registration form, please review the following requirements for IFS Endorsement and consider whether each of the bullets applies to you:

  • Do you have, or are on your way to having, at least 2-years, post Bachelor's, work experience providing relationship-based direct service to 0-36 month olds and their families?
  • Have you worked with, or are on your way to working with, at least 10 families, where the primary target of your intervention is a 0-36 month old?
  • Have you received, or are in the process of receiving, at least 24-hours of reflective supervision/consultation, from a qualified provider, during a 1-2 year time frame?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the remainder of this page.

Before completing the remainder of the registration form, please review the following requirements for ECFS Endorsement and consider whether each of the bullets applies to you:

  • Do you have or are on your way to acquiring at least 2-years, post Bachelor's, work experience providing relationship-based direct service to 3 up to 6-year olds and their families?
  • Have you worked with, or are on your way to working with, at least 10 families, where the primary target of your intervention is a 3 - up to 6-year old?
  • Have you received, or are in the process of receiving, at least 24-hours of reflective supervision/consultation, from a qualified provider, during a 1-2 year time frame?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the registration page.

Before completing the remainder of the registration form, please review the following requirements for IMHS Endorsement and consider whether each of the bullets applies to you:

  • Do you have, or are in the process of having, at least 2-years, post-graduate work experience with 0-36 month olds and their primary caregivers providing relationship-focused infant mental health service/intervention?
  • Have you received, or are in the process of receiving, at least 50-hours of reflective supervision/consultation, from a qualified provider, during a 1-2 year time frame?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the registration page.

Before completing the remainder of the registration form, please review the following requirements for ECMHS Endorsement and consider whether each of the bullets applies to you:

  • Do you have, or are in the process of having, at least 2-years, post-graduate work experience with 3 up to 6-year olds & their primary caregivers providing relationship-focused infant & early childhood mental health service/intervention?
  • Have you received, or are in the process of receiving, at least 50-hours of reflective supervision/consultation, from a qualified provider, during a 1-2 year time frame?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the registration page.

Before completing the remainder of the registration form, please review the following requirements for IMHM-C Endorsement and consider whether each of the bullets applies to you:

  • Do you have, or are in the process of having, at least 2-years, post-graduate work experience with 0-36 month olds and their primary caregivers providing relationship-focused infant mental health service/intervention?
  • Have you provided, or are in the process of providing, reflective supervision/consultation to others for at least 3-years?
  • Have you received, or are in the process of receiving, at least 50-hours of reflective supervision/consultation from a qualified provider during a 1-2 year time frame?
  • Have you demonstrated, or are in the process of demonstrating, leadership in the field of infant mental health?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the registration page.

Before completing the remainder of the registration form, please review the following requirements for ECMHM-C Endorsement and consider whether each of the bullets applies to you:

  • Do you have, or are in the process of having, at least 2-years, post-graduate work experience with 3 up to 6-year olds and their primary caregivers providing relationship-focused infant and early childhood mental health service/intervention?
  • Have you provided, or are in the process of providing, reflective supervision/consultation to others for at least 3-years?
  • Have you received, or are in the process of receiving, at least 50-hours of reflective supervision/consultation from a qualified provider during a 1-2 year time frame?
  • Have you demonstrated, or in the process of demonstrating, leadership in the field of infant and early childhood mental health?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the registration page.

Before completing the remainder of the registration form, please review the following requirements for IMHM-P Endorsement and consider whether each of the bullets applies to you:

  • Do you have, or are in the process of having, at least 3-years post-graduate experience working in policy/program administration related to the infant, young child-family field?
  • Have you demonstrated, or in the process of demonstrating, leadership in the field of infant mental health?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the registration page.

Before completing the remainder of the registration form, please review the following requirements for ECMHM-P Endorsement and consider whether each of the bullets applies to you:

  • Do you have, or are in the process of having, at least 3-years post-graduate experience working in policy/program administration related to the infant early childhood-family field?
  • Have you demonstrated, or in the process of demonstrating, leadership in the field of infant and early childhood mental health?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the registration page.

Before completing the remainder of the registration form, please review the following requirements for IMHM-R/F Endorsement and consider whether each of the bullets applies to you:

  • Do you have at least 3-years post-graduate experience working in a university and/or published research related to infant mental health principles and practices?
  • Have you demonstrated, or in the process of demonstrating, leadership in the field of infant mental health?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the registration page.

Before completing the remainder of the registration form, please review the following requirements for ECMHM-R/F Endorsement and consider whether each of the bullets applies to you:

  • Do you have, or in the process of having, at least 3-years post-graduate experience working in a university and/or published research related to early childhood mental health principles and practices?
  • Have you demonstrated, or in the process of demonstrating, leadership in the field of infant and early childhood mental health?
  • If you are unsure whether this is the correct category of Endorsement for you, please contact your association's Endorsement Coordinator, prior to completing the registration page.

Personal Information*

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:

Additional:


Documentation

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


Membership

mm/dd/yyyy

You must join or renew membership to RIAIMH (or another infant mental health association) when submitting this preliminary application.



Please review and verify all data before submitting!