2015 Proctored Examination Registration Form - NAPA Net

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2015 Proctored Examination Registration Form Please complete all sections of this registration form or register online at www.asppa.org/exams. Incomplete forms may delay processing. Examination fees are not refundable. Please complete and submit both pages of this form. Registration for RPA’s RPF-1, RPF2, TGPC-1, PFC-1 DB-A, and ESOP-A exams is available on the Certificate Program Exam Registration Form.

APPLICANT INFORMATION Please print all information legibly. Mr./Mrs./Ms. _____________________________________________________________________________________ (Circle one)

Last Name

First Name

MI

Daytime Phone Number ______________________________ Fax Number ___________________________________ Company __________________________________________Title _________________________________________ Email __________________________________________________________________________________________ Mailing Address ___________________________________________________________________________________ Work

Home

Check here if your address has changed since your last examination.

City ______________________________________________ State ____________________ ZIP _________________ If your name differs from that used on a previous application, please indicate prior name. Mr./Mrs./Ms. _____________________________________________________________________________________ (Circle one)

Last Name

First Name

MI

Which RPA credential(s) are you currently working to attain by taking this exam? TGPC

QPFC

QKA

QPA

CPC

FSPA

Not pursuing a credential

EXAMINATIONS Check the box next to the examination(s) for which you wish to register or register online at www.asppa.org/exams. Examination Window

Spring 2015

Fall 2015

Apr 1—Jun 25

Aug 3—Dec 3

Early Registration Final Registration Early Registration Final Registration Examinations

PFC-2

Plan Financial Consulting - 2

Product #

E15SP_PFC2 E15F_PFC2 E15SP_TGP2

TGPC-2 Tax-Exempt & Governmental Plan Consultant-2 E15F_TGP2

Received at ASPPA By Apr 30

Received at ASPPA By May 14

Received at ASPPA By Sep 24

Received at ASPPA By Oct 29

Member*/Nonmember

Member*/Nonmember

Member*/Nonmember

Member*/Nonmember

$237/ $263

$314/ $340

$237/ $263

$314/ $340

$237/ $263

$314/ $340

$237/ $263

$314/ $340

DC-1

Defined Contribution Administrative Issues Basic Concepts

E15SP_DC1 E15F_DC1

$237/ $263

$314/ $340

$237/ $263

$314/ $340

DC-2

Defined Contribution Administrative Issues Compliance Issues

E15SP_DC2 E15F_DC2

$237/ $263

$314/ $340

$237/ $263

$314/ $340

DC-3

Defined Contribution Administrative Issues Advanced Topics

E15SP_DC3 E15F_DC3

$237/ $263

$314/ $340

$237/ $263

$314/ $340

DB

Basics of Defined Benefit Plans

E15SP_DB E15F_DB

$237/ $263

$314/ $340

$237/ $263

$314/ $340

$314/ $340

$391/ $417

$314/ $340

$391/ $417

$314/ $340

$391/ $417

$314/ $340

$391/ $417

CPC

Certified Pension Consultant**

A-4

Advanced Actuarial Practice***

E15SP_CPC E15F_CPC E15SP_A4 E15F_A4

Internationally Administered Examinations+ DC-1

Defined Contribution Administrative Issues Basic Concepts

E15SP_DC1_I E15F_DC1_I

$288/ $314

$366/ $391

$288/ $314

$366/ $391

DC-2

Defined Contribution Administrative Issues Compliance Issues

E15SP_DC2_I E15F_DC2_I

$288/ $314

$366/ $391

$288/ $314

$366/ $391

*Memberships are individual. If you are not personally a member, please pay the nonmember rate. Grades will not be released to a candidate who fails to pay an outstanding examination or course fee. See page 2 of this form for registration deadline information. ** The CPC examination is only offered on June 11, 2015 in the spring window and November 12, 2015 in the fall window. *** The A-4 examination is only offered on June 11, 2015 in the spring window and November 12. 2015 in the fall window. + To schedule an international exam (DC-1, DC-2), candidates should visit www.prometric.com/ASPPA and schedule an appointment online or call the number provided by region. RPA 2015 Proctored Examination Registration Form

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2015 Proctored Examination Registration Form Candidate’s Name

_______________________________________________

METHOD OF PAYMENT (check one) Visa

MasterCard

American Express

Discover

Check or money order

(enclosed)

Total Amount $________

Card No:__________________________________________________ Expiration Date: ________________________ Cardholder’s Name: ____________________________ Authorized Signature: ________________________________ This registration form must be accompanied by payment. By registering for RPA examination, candidates acknowledge that they have read and agree to abide by the testing regulations and policies set forth by RPA.

MISCELLANEOUS INFORMATION If you are an individual with a disability, please specify any accommodation you require:

EXAMINATION DEADLINES To qualify for early registration, registration forms accompanied by the early registration fee must reach the ASPPA office no later than April 30, 2015 for the spring examinations and September 24, 2015 for the fall examinations. Registrations received after the early registration date will be charged the final registration fee. To qualify for final registration, registration forms accompanied by the final registration fee must reach the ASPPA office no later than May 14, 2015 for the spring examinations and October 29, 2015 for the fall examinations. Registrations received after the final registration date will be returned to the candidate. The postmark date is irrelevant. Exams are nontransferable after the final registration date (May 14, 2015 and October 29, 2105). Grades will not be released to a candidate who fails to pay an outstanding examination or course fee. We recommend that you allow at least two weeks for delivery of your registration. RPA cannot be responsible for delay or loss of your registration by the delivery or the postal service. If a registration form is faxed, please save the confirmation form. ASPPA cannot confirm receipt of a registration form over the phone. A candidate who does not sit for a scheduled examination and does not request to postpone by the postponement deadline forfeits his/ her examination fee. Please refer to the RPA Examination Postponement Form for details. Mail completed registration form with check payment to: ASPPA | PO Box 34725 | Alexandria, VA 22334-0725 Fax completed registration form with credit card information to: 703.516.9308 Appointment Rescheduling Policy After registering and receiving an eligibility email (approximately 6-8 weeks prior to the exam window offering) a candidate can reschedule the date, time and location of a scheduled examination appointment within the same testing window – the candidate must contact Prometric by telephone (1-888-215-4136) or through their online system (www.prometric.com/ ASPPA). Fees do apply and will be collected by Prometric at the time of rescheduling. The fees for 2015 include:  Reschedule appointment 30 or more days before exam appointment – no fee is charged.

 

Reschedule or cancel appointment 2-29 days before exam appointment - $35 fee. Reschedule or cancel appointment less than 2 days (48 hours) before exam appointment:

  

$92 fee for PFC-2, TGPC-2, DC-1, DC-2, DC-3 or DB and $101 fee for CPC $121 fee for internationally administered DC-1 and DC-2 exams (visit www.prometric.com/ASPPA to reschedule by phone (phone number provided by region in which you are testing or online)

We strongly recommend you do not schedule your examination appointment on the last day of the testing window. If, at all possible, we also recommend not scheduling your appointment during the last week of the testing window. Unforeseen circumstances may prevent you from testing on your scheduled day or time, and unfortunately we will not be able to assist you with rescheduling. Your examination may need to be postponed to a future window (additional fees involved) and/or you may have to forfeit your examination fee.

If you are faxing your registration, please do not send a copy via mail. ASPPA 2015 Proctored Examination Registration Form

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