Certification Application and Reference Evaluation Forms

The certification application and reference evaluation forms are provided below in Adobe PDF format.  Please download them by clicking on the following links.

application.pdf (For CHCM - CHSP - CPSO - CPSM - CHEP)

reference_eval.pdf (For CHCM - CHSP - CPSO - CPSM - CHEP)

If you do not have the free Adobe Reader, please click on the "Get Acrobat Reader" icon below to obtain it. 

Requirements

The application fee stated in the brochure must accompany the completed application. Mail to the address on the front page. Add $10.00 if you live outside of North America. 

THE APPLICATION FEE IS NOT REFUNDABLE.APPLICATION AND EXAMINATION FEES MUST BE PAID A MINIMUM OF 4 WEEKS PRIOR TO THE DATE OF EXAMINATION. IF TAKING THE EXAM AT A COLLEGE OR MILITARY TESTING CENTER

The Board will contact all participants with exam results within (4) weeks after the date of the exam provided all required documents including job descriptions, college transcripts and fees have been received.

Instructions

Insert all required information on the application form.   Attachments may be included as back up, but not as a substitute for completing the application form. Check appropriate certification boxes. There is a separate application fee for each designation desired.

Type or print legibly.

If extra space is needed for qualification data, use blank space at end of form.

Forward Reference Evaluations to persons listed as references.

Enclose or have forwarded:

Official job descriptions

Official college transcripts

Training certificates

Professional certifications or registrations

Sign and mail completed application with appropriate fee to the following address :

BCHCM

P.O. Box 515

Helena, AL 35080

For UPS, FedEx, or DHL deliveries send to:

PLEASE NOTE: FAXED APPLICATIONS & SUPPORTING DOCUMENTS WILL NOT BE ACCEPTED.