American College of Sexologists | Institutional Membership Application

Institutional Membership Application

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"Certification" Requirements
The institute, college or school may be located on a campus or online with training to meet the follow criteria:
a. Degrees or certifications related to Human Behavior, Public Health, Sex Education, Relationship, Love, Intimacy or Sex Coaching, Sexology, Erotology, Somatic, Esoteric, Alternative Lifestyle, Adult Toys & Novelties or Erotic Filmography.
b. Transcript(s) documenting curriculum of programs and/or courses with a minimum of 300 hours of academic training related to the field of above studies.
c. Institute must have been in operation for a minimum of (2) two years.
d. Institutional certification will be good for three (3) years from date of issue.
e. A renewal application with a $200.00 fee will be required every three (3) years thereafter to retain Institutional Membership status.
Institution Name*
Your Name*
First Last
Your Title/Position*
Email*
Password*
Enter Password Confirm Password

Your e-mail address along with this password will be used to log into our website to make membership renewal payments.
Website
Institution Social Network Links
Social Network Name URL

Click the + icon to the right to add more social networks
Institution Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
History
Institution Established
Years
Degrees Offered
Institution's Program for Certification & Membership
Please provide us with the title/degree as well as the academic duration (hours/units/weeks/months/years) of the program you are applying for.
Title/Degree*
Hours/Units/Weeks/Months/Years*

References
Please supply three (3) references from students that have graduated from the Institute.
Reference Name 1
First Last
Reference Degree Earned 1
Reference Address 1
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference Phone 1
Reference Email 1
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Reference Name 2
First Last
Reference Degree Earned 2
Reference Address 2
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference Phone 2
Reference Email 2
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Reference Name 3
First Last
Reference Degree Earned 3
Reference Address 3
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference Phone 3
Reference Email 3

File Upload
Please upload your scanned documentation of degree/program/certificate training.
Drop files here or

Accepted file types: jpg, pdf.

*
- By checking this box, I agree to have my institute, contact information and specialties listed in the membership directory.
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- I hereby certify that the information submitted in this application is accurate to the best of my knowledge, and permit The American College of Sexologists International to verify any information I have submitted.
Terms & Conditions
Disclaimer
This website is provided “as is” without any representations or warranties, express or implied. The American College of Sexologists International makes no representations or warranties in relation to this website or the information and materials provided on this website.

Nothing on this website constitutes, or is meant to constitute, advice of any kind. If you require advice in relation to any [legal, financial or medical] matter you should consult an appropriate professional.

Indemnity
You agree to indemnify and hold The American College of Sexologists International its subsidiaries, affiliates, officers, agents, and other partners and employees harmless from and against any and all liability and costs incurred by The American College of Sexologists International or the Affiliates in connection with any claim arising out of any breach or alleged breach of any of your obligations set forth herein. Additionally, you agree to that The American College of Sexologists International is not liable for any indirect, special or consequential loss; or for any business losses, loss of revenue, income, profits or anticipated savings, loss of contracts or business relationships, loss of reputation or goodwill, or loss or corruption of information or data.

Liability
Under no circumstances shall The American College of Sexologists International be liable for direct, indirect, incidental, special, consequential or exemplary damages (even if The American College of Sexologists International has been advised of the possibility of such damages), resulting from any aspect of your use of The American College of Sexologists International website, whether the damages arise from use or misuse of the website, from inability to use The American College of Sexologist International website, or the interruption, suspension, modification, alteration, or temporary termination of The American College of Sexologists International website. Such limitation shall also apply with respect to damages incurred by reason of other services or products received through or advertised in connection with The American College of Sexologists International site. These limitations shall apply to the fullest extent permitted by law. In some jurisdictions, limitations of liability are not permitted. In such jurisdictions, some of the foregoing limitation may not apply to you.

As with any on-line interaction and electronic communication, there is an inherent risk involved in transmitting any information via the Internet. The American College Of Sexologists International does not and cannot guarantee that its system is free from hackers or viruses or that information provided by users to The American College Of Sexologists International will not be stolen or otherwise surreptitiously obtained. nugs.net is not responsible or liable for any infections or contamination of your system or delays, inaccuracies, errors, or omissions arising out of your use of this Site or with respect to the Materials contained on this Site. You hereby acknowledge and understand that such risk is inherent in interacting with any website, including this Site, and take full responsibility for any harm, danger or damage that ensues due to any such breach in security. Pursuant to these Terms of Use, The American College of Sexologists International expressly disclaims any such liability.

The American College of Sexologists International is not responsible or liable for any infections or contamination of your system or delays, inaccuracies, errors, or omissions arising out of your use of this Site or with respect to the Materials contained on this Site. You hereby acknowledge and understand that such risk is inherent in interacting with any website, including this Site, and take full responsibility for any harm, danger or damage that ensues due to any such breach in security.

Pursuant to these Terms of Use, The American College of Sexologists International expressly disclaims any such liability. In addition, you agree to be responsible for obtaining and maintaining all telephone, computer hardware and other equipment needed for access to and use of this Site and you shall be responsible for all charges related thereto will not be stolen or otherwise surreptitiously obtained.

The American College of Sexologists International is not responsible or liable for any infections or contamination of your system or delays, inaccuracies, errors, or omissions arising out of your use of this Site or with respect to the Materials contained on this Site. You hereby acknowledge and understand that such risk is inherent in interacting with any website, including this Site, and take full responsibility for any harm, danger or damage that ensues due to any such breach in security. Pursuant to these Terms of Use, The American College of Sexologists International expressly disclaims any such liability. In addition, you agree to be responsible for obtaining and maintaining all telephone, computer hardware and other equipment needed for access to and use of this Site and you shall be responsible for all charges related thereto.

In addition to any other rights of the parties set forth herein, either you or may cancel or terminate this Agreement at any time in accordance with the help instructions. The American College of Sexologists International also reserves the right to restrict, suspend or terminate your access to the Fee-Based Services and/or any part of the Site, in whole or in part, without notice, with respect to any breach or threatened breach of any portion of this Agreement. If The American College of Sexologist International terminates this Agreement based on a breach of any portion of this Agreement, The American College of Sexologists International reserves the right to refuse to provide any Fee-Based Services or other services to you in the future.

You agree that we may, in our sole discretion, at any time and without cause, may terminate your use of the Site or any portion of the Site, without liability to you.

Reasonableness
By using this website, you agree that the exclusions and limitations of liability set out in this website disclaimer are reasonable. If you do not think they are reasonable, you must not use this website.
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- By checking this box, I agree to the terms and conditions above.
Signature
Use your mouse to sign your name in the box above.
Institutional Membership Application Fee
Price: $300.00
Please pay US$300.00 non-refundable 3-year application fee via PayPal. Renewal fee thereafter will be US$200.00 every 3 years.
Once you click Submit Application & Pay you will be directed to PayPal to pay the application fee of US$300.00. If you do not have a PayPal account, be sure to select the option "Pay with a debit or credit card, or Bill Me Later" to get the standard credit card form.

Institutional Membership Application

Institutional Membership Application

Step 1 of 4

"Certification" Requirements

History

Institution's Program for Certification & Membership

References

File Upload

Terms & Conditions

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