Renewal by Examination Application

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Please use this form to submit your renewal by examination application.

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Certification you wish to renew

Confirm Email*

Certification ID Number

Certification Expiration Date

"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

Certification for Renewal*

CPFC or CEPF

Peer Mentor

Other

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Name

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.

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Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Phone

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Employer 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.

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Job Title

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Work Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Phone

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Email

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Which address would you like any physical mail sent to?

Home

Work

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Which email would you like notifications sent to?

Personal

Work

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.

You are required to have a minimum of 6 months work experience. Please provide a brief description of your work experience and the amount of time you spent in each field.*

An Applicant or Certificant is required to have a minimum of a High School diploma or GED. Higher levels of education are preferred. An Applicant or Certificant must provide information about their highest level of formal education obtained, including the following information. Fincert.org reserves the right to verify reported information.

I have obtained my High School diploma or GED*

Yes

No

Highest degree level attained*

Area(s) of study*

Institution from which degree was attained*

Total

Payment Type*

I will make payment today online

I will make payment by phone

My employer or card holder has, or will, make payment by phone

Cardholder Name

First Last

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Cart

Renewal by Examination Application

Certification Renewal by Examination