NACM Brochures 2017 NACM Professional Certification Program - Page 24

NACM Exam Retake Form Mr./Ms. First Name Middle or Maiden Name Birth Month and Day (MM/DD) Company Business Telephone Business Fax Business Email Address Home Telephone Last Name Local Affiliate Office I plan on attempting a designation exam on the date indicated below. I have completed this form as notification of my intent and will return it along with the accompanying non-refundable fee by the paperwork deadline for the specified exam date. I understand that all exam fees must be paid prior to attempting the exam. I further understand that I have up to three years from the date of my written confirmation to pass the exam and that after this time I will have to reapply. The exam will be given at my local Affiliate office, unless special advanced arrangements have been made. I have notified my Affiliate office to confirm my status and time to attempt the exam. If there is a need to reschedule the exam date, I will notify the NACM-National Education Department in writing via mail or fax two weeks prior to my original selected exam date. I understand that if I do not reschedule my exam appointment and fail to show up to take the exam, I will be subject to a rescheduling/no-show fee. Exam Date: q March 5, 2018 (Paperwork Deadline: January 26) q June 10, 2018 – Exam given at NACM’s Credit Congress in Phoenix, AZ only (Paperwork Deadline: April 20) q July 23, 2018 (Paperwork Deadline: June 1) q November 5, 2018 (Paperwork Deadline: September 14) Exam to be taken: (Choose one) q CBA SM ($99) q CBF SM ($99) q CCE ® ($125) q A check, made payable to NACM-National Education Department, is attached. Charge to: q VISA q MasterCard q American Express q Diners Club Card Number Card Security Code Cardholder’s Name Cardholder’s Signature q Discover Card Expiration Date Credit Card Billing Address q Check here to opt out of the congratulatory listing published in Business Credit magazine. Return completed form to: NACM Education Dept., 8840 Columbia 100 Parkway, Columbia, MD 21045-2158 • Fax: 410-740-5574 • Email: 24