Professional Directory Application Step 1 of 5 20% Contact InformationThe Contact Information below will not be displayed on the directory and for the use of IDA only. IDA Membership #(Required)To be included in the directory, Individual professionals must have an IDA professional membership. Clinics, centres & schools must have a school, institutional or corporate membership. Name(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required) Listing InformationIf your application is approved, the Listing Information you provide below will be displayed on our website directory. Listing Type(Required)Is this listing for an individual professional, clinic/centre or school?Individual professionalCentre/ClinicSchoolDirectory Contact Name(Required)Enter the name of the individual professional. For a school or clinic/centre, enter the name of the contact individual. Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Directory Professional Title(Required) Directory Email(Required) School Name(Required) Clinic / Centre Name(Required) Directory Phone NumberLeave blank if you do not want to have a phone number listed in the directory.Directory Contact AddressLeave blank if you do not want to have an address listed in the directory. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands WebsiteLeave blank if you do not want to have a website listed in the directory. Professional Service InformationPopulations/age groups(Required) Preschool Elementary School High School Adult Instructional services offered (areas of instruction/intervention/remediation)(Required) Handwriting Math Reading Reading comprehension Spelling Teacher/therapist training Written expression Other areas of instruction offeredList any other areas of instruction offered. Click "+" to add additional lines. Add RemoveDescribe the structured literacy / science of reading approaches or programs used(Required)Language(s) of Service(s)(Required) English French Other In what other language(s) are services provided?(Required) Teacher credentials (school)(Required)Please provide a brief description of the relevant training and credentials of the teachers in the school (particularly with regard to training in structured literacy instruction).Professional credentials(Required)Please provide a brief description of the training and credentials of the professionals in the centre/clinic (particularly with regard to training in structured literacy instruction). Individual Professional Directory ServicesPopulations/age groups(Required) Preschool Elementary School High School Adult Instructional services offered (areas of instruction/intervention/remediation)(Required) Handwriting Math Reading Reading comprehension Spelling Teacher/therapist training Written expression Other Other areas of instruction offeredList any other areas of instruction offered. Click "+" to add additional lines. Add RemoveLocation(Required)I offer the above services in the following settings (check all that apply): Private clinic/office Home office Will travel to another location (eg. client's home, library, school) Online/remote Language(s) of service(Required) English French Other In what other language(s) are services provided? Other professional services(Required) None Advocacy Mental health therapy / counselling Other assessments (eg. standardized and/or informal) Psycho-educational assessments (psychologists only) Legal Other Other servicesList any other relevant services that you offer. Click on the "+" button to add more rows. Add Remove TrainingEducational diplomas/degrees(Required) College Diploma Bachelor Degree Masters Degree Doctoral Degree Structured Literacy Training(Required)Provide details about relevant structured literacy training you have taken (certification details are below). Click on the "+" button to add more rows.OrganizationTraining Program/Course nameYear takenClassroom/Online# hours coursework# hours practicum Add RemoveProfessional Certifications(Required)Please click all that apply. You must provide proof of certification (uploaded copy) for each certification specified. Academic Language Therapy Association (ALTA) Educational Therapist Educational Assistant Early Childhood Educator Basics of Decoding and Spelling Instruction (BDSI) International Dyslexia Association/Center for Effective Reading Instruction (IDA/CERI)) Orton - Gillingham International Multisensory Structured Language Educational Council (IMSLEC) LETRS National Institute for Learning Development (NILD) Provincial Teaching License Psychologist Speech Language Pathologist Wilson Reading System Other Specify IDA/CERI certification(Required)Structured Literacy/Dyslexia Interventionist (fka Certified Dyslexia Practitioner (CDP))Structured Literacy/Dyslexia Specialist (fka Certified Dyslexia Therapist (CDT))Structured Literacy Classroom Teacher Knowledge CertificateSpecify AOGPE certification(Required)Classroom EducatorAssociate LevelCertified LevelFellow-in-trainingFellowSpecify IMSLEC Certification(Required)TeacherTherapistSpecify ALTA certification(Required)Certified Academic Language Practitioner (CALP)Certified Academic Language TherapistInstructor of Certified Academic Language Practitioner (ICALP)Qualified Instructor (QI)Specify Wilson certification(Required)Level 1Level 2Specify Other Certifications (list)Click on '+' to add more rows. Add RemoveProof of Certifications(Required)Please upload proof of certifications (multiple files if necessary, PDF or JPG only) Drop files here or Select files Accepted file types: jpg, pdf, png, Max. file size: 64 MB. Verification & SignaturePlease read and select the boxes carefully.Verification(Required) By submitting this application, I agree to accept IDA Ontario's decision whether to approve this listing request. I certify and attest that all statements and representations I have made in this form are true and that I have the credentials, education, degrees, licenses and /or certifications that are legally or customarily required in my file to perform the services I have checked-off on this form. Further, I certify and attest that the credentials, education, degrees, licenses and/or certifications are current and have been issued by an institution or body accredited or empowered to do so. I certify and attest that I have not been convicted of any felony or crimes involving professional malfeasance or abuse of any kind. I give IDA Ontario permission to share my name and contact information for the sole purpose of providing professional referrals. It is my responsibility to keep this listing up to date. I understand that I must maintain my membership in the International Dyslexia Association to remain in IDA Ontario's Professional Directory Signature(Required)Typing your name here constitutes your authorization and approval to include this listing in the IDA Ontario Professional Directory, if approved. CAPTCHA
