Certification Renewal by Continuing Education Step 1 of 6 16% HiddenPlease use this form to submit your renewal by continuing education application. Certification you wish to renew*Select your certificationCertified Personal Finance Counselor (CPFC)Certified Educator in Personal Finance (CEPF)Certified Consumer Debt SpecialistCertified Consumer Receivables CounselorCertified Residential Housing CounselorConfirm Email* Certification ID Number Certification Expiration Date Status of Renewal*Active Renewal by CEULate Renewal by CEU (Please select if your certification expired between 1 and 90 days ago)"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."* I Agree HiddenName First Last Please complete all of the following fields with your personal/home contact information. We will request your work details on a following page.HiddenHome Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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 Country HiddenPhoneHiddenEmail HiddenEmployer Name (If self-employed, please enter your first and last name in this field) 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.HiddenJob Title HiddenWork Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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 Country HiddenPhone*HiddenWhich address would you like any physical mail sent to? Home Work HiddenWhich email would you like notifications sent to? Personal Work Completed CEU Courses*CEU Approval CodeCourse NameCEU CreditsDate Completed Please report all required CEU hours earned on the CEU Reporting Form below. To renew a certification with CEUs, certificants must complete 16 hours of continuing education, two of which must be in ethics. Completion of CEUs should not be individually or separately reported at the time they are earned during the Certification Period. CEUs in excess of the requirement should not be reported. Supporting documentation, including documentation confirming attendance, should not be sent to Fincert unless specifically requested by Fincert. To find the CEU Approval Code, please see the CEU Pre-Approved List. Have you ever been convicted of a felony?* Yes No Please provide each date of conviction, the felony or felonies in question, and a description of the circumstances of the conviction. 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?* Yes No Please provide each date of revocation, suspension or disciplinary action, the name of the licensing or certification body, and a brief explanation of the circumstances. 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?* Yes No Please provide each date of revocation, suspension or disciplinary action, the name of the licensing or certification body, and a brief explanation of the circumstances. Have you ever filed bankruptcy?* Yes No Please provide each date on which you filed for bankruptcy and briefly explain the circumstances of the bankruptcy. Have you ever been or are you now subject to a judgment lien?* Yes No Please provide each date a judgment lien has been issued against you, provide the jurisdiction in which the lien was issued, and briefly explain the circumstances of each judgment lien. Highest degree level attained*Highest degree level attainedHigh School/GEDSome CollegeAssociates DegreeBachelors DegreeGraduate DegreeArea(s) of study* Institution from which degree was attained* Policy Review Affirmation* Yes “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* Yes “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* Yes “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* Yes “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:* Yes “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* Yes “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* Yes “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* Yes “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* Yes “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* Yes “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.”"I have read this Application Form carefully, and I understand the meaning of its provisions and agree to abide by them."* Enter your full name as your electronic signature. Total $0.00 Coupon Payment Type* I will make payment today online I will make payment by phone I have already submitted payment My employer or card holder has, or will, make payment Cardholder Name First Last Billing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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 Country Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Expiration Date Security Code Cardholder Name