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Certification Enrollment Application

Certification Enrollment

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"I understand and agree that if I do not meet all eligibility criteria and Candidate Fitness Standards for certification my Application will be denied and that no refund will be granted. I also understand that an Applicant Pre-Screening Form has been made available so that I may determine for myself whether I meet all eligibility criteria and Candidate Fitness Standards for certification prior to the payment of any fees."*
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Name
Please complete all of the following fields with your personal/home contact information. We will request your work details on a following page.
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Home Address
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Work Contact Information - Please complete all of the following fields with your work information. We will NOT send any communication, electronic or physical, to a work address unless you request it as your default mailing address.
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Work Address
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Which address would you like any physical mail sent to?
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Which email would you like notifications sent to?
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Which phone number would you prefer we use to contact you?
Have you ever been convicted of a felony?*
Have you ever had a professional license or certification related to the financial services, financial counseling or education field(s) revoked, suspended or otherwise subject to disciplinary action?*
Have you ever had a professional license or certification NOT related to the financial services, financial counseling or education field(s) revoked, suspended or otherwise subject to disciplinary action?*
Have you ever filed bankruptcy?*
Have you ever been or are you now subject to a judgment lien?*
I have obtained my High School diploma or GED*
Policy Review Affirmation*
"I have read and understand Fincert.org's Certification Policies and Standards. I understand that these Certification Policies and Standards are subject to change at any time, with or without notice, and that I am solely responsible for ensuring that I review any updates to these Certification Policies and Standards when they are published.
Application, Renewal and Recertification Procedure Review Affirmation*
"I have read and understand Fincert.org's procedures, including but not limited to the Application, Renewal and Recertification Procedures. I understand that these procedures are subject to change at any time, with or without notice, and that I am solely responsible for ensuring that I review any updates to these procedures when they are published."
Continuing Education Affirmation*
"I understand that after becoming certified through Fincert.org, I will be required to complete continuing education unit requirements. I have read and understand Fincert’s procedures, including but not limited to the CEU Procedures. I understand that these procedures are subject to change at any time, with or without notice, and that I am solely responsible for ensuring that I review any updates to these procedures when they are published."
Ethical Affirmation*
"I have read, understand and will abide by Fincert’s Code of Ethics, found in Article II of Fincert.org's Certification Policies and Standards, which I understand applies equally to both Applicants and Certificants. I further understand failure to abide by the Code of Ethics may be grounds for the immediate denial, suspension or revocation of certification."
Professional Conduct Affirmation:*
"I have read, understand and will abide by Fincert’s Code of Professional Conduct, found in Article III of Fincert Certification Policies and Standards, which I understand applies equally to both Applicants and Certificants. I further understand failure to abide by the Code of Professional Conduct may be grounds for the immediate denial, suspension or revocation of certification."
Background Check Notice*
"I understand that Fincert.org reserves the right to check my criminal, employment and education history including, without limitation, criminal/driving records, references, and release of licensing and investigatory information possessed by any state, local, or federal agency. These checks may be conducted, with or without cause, at any time during the thirty-six month period following the submission of an Application for Certification or Application for Renewal of Certification. I hereby agree to provide such additional information, signed waivers or other such assistance as Fincert may from time to time request from me to conduct these background checks. I further acknowledge and agree that failure to provide such additional information or assistance shall constitute grounds for immediate denial, suspension or revocation of certification."
No Employment or Agency*
"I understand that acceptance of this Application and/or certification by Fincert.org does not constitute an offer of employment with Fincert.org or any form of agency on its behalf."
Fees Non-Refundable*
"I understand that any fees paid to Fincert.org with the submission of this Application, as well as any fees paid in the future for renewal, recertification, or for any other purpose, are completely non-refundable."
Regulatory Reporting*
"I understand that Fincert.org may provide information about Applicants or Certificants to regulatory authorities and others upon request, or as otherwise required by law."
Affirmation of Accuracy*
"By submitting this Application, I state that the information provided on this Application and any other information that I have provided is accurate and true to the best of my knowledge and ability to determine. Further, I understand that providing inaccurate information to Fincert.org or its authorized representative(s) may be grounds for immediate denial or revocation of certification without refund."
Enter your full name as your electronic signature.
If your employer will be submitting payment, please direct them to: https://fincert.org/online-payment-form/. Thank you!
Cardholder Name
Billing Address
Credit Card
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date
 
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