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CFPS Application Form

The document is an application for the Certified Fire Protection Specialist (CFPS) program. It requests contact information from the applicant and details their eligibility criteria, which includes a combination of education and work experience dedicated to reducing fire loss. It provides instructions on submitting payment and sitting for the computer-based or paper exam. Upon passing the exam, successful candidates will be included in the public CFPS registry unless they opt-out.

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devilrakz
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293 views

CFPS Application Form

The document is an application for the Certified Fire Protection Specialist (CFPS) program. It requests contact information from the applicant and details their eligibility criteria, which includes a combination of education and work experience dedicated to reducing fire loss. It provides instructions on submitting payment and sitting for the computer-based or paper exam. Upon passing the exam, successful candidates will be included in the public CFPS registry unless they opt-out.

Uploaded by

devilrakz
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Certified Fire Protection Specialist (CFPS) Program Application

Email completed application to:

For Internal Use Only

[email protected]

Date Received: ________________

NFPA Certification Department


1 Batterymarch Park, Quincy, MA 02169
(P) 1-800-597-6481 x7509 (F) 617-984-7127
Web Page: www.nfpa.org/certification

Database:

Pmt. Received:

Meets Eligibility Criteria:

(TYPE OR PRINT ALL INFORMATION; INCOMPLETE APPLICATIONS WILL BE RETURNED)


APPLICANT NAME: ____________________________________________ (As will be printed on certificate)
E-mail: _______________________________________________________________________________________
Home Mailing Address: _________________________________________________________________________
City: ______________________ State: _____________ Country: ___________________ Zip Code: ___________
Home Phone: _____________________ Mobile Phone: ___________________
PLEASE SELECT only ONE OF THE FOLLOWING CFPS EXAM OPTIONS
COMPUTER BASED TEST: The CFPS examination is available on demand as a computer-based test at test
assessment centers throughout the World. Upon receipt of the CFPS examination application and test fee, the
applicant will receive their authorization letter with instructions on how to schedule the computer- based exam.
A list of Computer-based test centers is located at the test administrators website: www.isoqualitytesting.com.
PAPER AND PENCIL (P&P) FORMAT : The CFPS examination is also offered in paper & pencil format.
Please submit application at least 4 weeks prior to test date.
SEE NFPAs WEBSITE FOR UPCOMING P&P EXAM DATES and specify below.
DATE:

LOCATION:

Please check the following box if you will need spcecial accommodation for handicap or disabliity:
I require special accommodations for testing due to sensory, visual, orthopedic, or other handicaps that will
prevent me from taking the examination under standard conditions. I understand that I provide a separate written
request for special accommodation with this application and that I may be required to provide supporting
documentation from healthcare professionals. (See page 6 of the Applicant Handbook for policy details)
CURRENT EMPLOYMENT
Company Name: ______________________________ Dates of Employment ____________________ to present
Company Address: ______________________________________________________________________________
City: ___________________________ State: _________ Country: ________________ Zip Code: _______________
Business Phone: ________________ Mobile Phone: ________________ Email: _____________________________
Title:________________________________ Field of Expertise: __________________________________________
Supervisors Name (Print): _______________________________________ Title: ____________________________
I verify that ________________________________ is performing the duties and responsibilities as identified above.
Signature of Supervisor or Human Resources Contact _________________________________ Date: ____________

(Page 1 of 2)
24

CFPS Application (Page 2 of 2)


VERIFICATION OF ELIGIBILITY CRITERIA
Candidates must meet one of the following criteria to be eligible to take the CFPS examination. (Select One)
1. High school diploma,
plus six years of verifiable
work experience dedicated to
curtailing fire loss, both
physical and financial. Resume
REQUIRED.

2. Associates degree in
engineering, technology or other
related discipline from an accredited
college or university, plus four
years verifiable work experience
dedicated to curtailing fire loss,
both physical and financial.
Copy of College Diploma or
Transcript AND Resume
REQUIRED.

3. Bachelors degree in
engineering, technology, or other
related discipline from an accredited
college or university, plus two years
of verifiable work experience
dedicated to curtailing fire loss,
both physical and financial.
Copy of College Diploma or
Transcript AND Resume are
REQUIRED.

The CFPS Practice Examination (Item # CFPSPE) can be purchased from NFPA Customer Sales at
800-344-3555 or online from the NFPA Online Catalog at www.nfpa.org.

PAYMENT INFORMATION
Amount Enclosed $

Certification Exam Fee: $350.00

_____________

Check. (Please make checks payable to NFPA Certification Department)


Credit C
MasterC
scov
Credit Card # ________________________________Card Exp. Date: _____________________
Name on Card: ______________________________Signature:___________________________
Please Note: No-shows forfeit all application fees.
AFFIRMATION AND AUTHORIZATION: I agree to inform and release to the CFPS or its agents all pertinent
information related to situations that arise in connection with my application and/or certification, both now and in the
future. I understand the CFPS reserves the right to verify any and all information in this application or in connection
with my certification. Therefore, I understand and agree that my failure to provide accurate, true and correct
information, respond to authorized CFPS requests for additional information, or abide by CFPS policies, procedures
or Code of Conduct and Ethics shall constitute grounds for rejection of my application or denial or revocation of my
certification. I understand the demographic information provided on this application is confidential and will be used
for aggregate purposes only. I understand that I am prohibited from transmitting information regarding examination
questions or content in any form to any person or entity, and understand that failure to comply with this prohibition
may result in my certification being revoked and/or legal action being taken against me. I acknowledge and agree that
the CFPS Certifying Body shall have the right to revoke or invalidate any examination score, with or without a finding
of fault or misconduct on my part, if data forensic analysis or other credible evidence establishes a reasonable
possibility that a score is not valid or that the integrity or security of the examination was compromised.

(Signature) ___________________________________________(Date)____________________
I understand that my name, address and contact information will become part of the public CFPS Registry upon
successful completion of the examination, unless I opt out by checking the bottom box below.
(choose one)
Yes, list me in the online CFPS registry (this is the common choice)
No, DO NOT list me in the online CFPS registry (this is not common)

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