PMI-SP® Certification Application

PAGE 1 OF 6 | YOUR INFORMATION

Tips for completing this form:

• Hand-write your information clearly in blue or black ink onto a printed form and submit it by postal mail.
• Type your information into the PDF. If you have PDF-editing software like Adobe® Acrobat® or Foxit® Reader, you can save your data. Otherwise, you will
only be able to type your information, then print out the form and send it to PMI.
All information and documentation must be in English. Faxed or scanned copies will not be accepted.

PMI Member ID#: If you are a PMI member, you have an ID number. To find your ID number, log in to myPMI and select “Profile” from the
top navigation, then select “Membership Profile” from the left navigation. If you have any questions, you may contact
PMI Customer Care at +1 610-356-4600, or send an email to [email protected].

Instructions:
In this section you are being asked to PRINT your name for three separate purposes. It is very important that you complete this section carefully.
Section 1. Please print your name as you wish to be referred to in correspondence from PMI.
Section 2. Please print your name as it appears on your government-issued identification that you will present at the testing center.
Section 3. Please print your name as you wish it to appear on your PMI-SP certificate.

Section 1. Name for correspondence from PMI:

Prefix (Mr., Mrs., Ms., Dr.): First Name (given name): Middle Name:

Last Name (family name, surname). Candidates with only a single name should use last name field: Suffix:

Section 2. Name on government-issued identification:   Check here if same as above.

Prefix (Mr., Mrs., Ms., Dr.): First Name (given name): Middle Name:

Last Name (family name, surname). Candidates with only a single name should use last name field: Suffix:

Section 3. Name for your PMI-SP certificate:   Check here if same as above.
Prefix (Mr., Mrs., Ms., Dr.): First Name (given name): Middle Name:

Last Name (family name, surname). Candidates with only a single name should use last name field: Suffix:

CONTACT INFORMATION
*If paying by credit card, your billing
address must match the address on
Prefered Mailing Address:  Home  Business Billing Address*:  Home  Business your credit card statement.
Home Address: City: State/Province/Territory:

Country: Zip/Postal Code:

Business Address: Business Name:

City: State/Province/Territory:

Country: Zip/Postal Code:

PRA-200-2013
 PMI-SP® Certification Application
PAGE 2 OF 6 | YOUR INFORMATION (Continued)

Preferred E-mail:  Personal  Work Preferred Phone:  Home  Business  Mobile

E-mail: Phone: Extension:

Preferred Fax:  Home  Business

Fax:

Applicant’s Primary Industry:

 Aerospace  Construction  Finance  Manufacturing

 Automotive  Consulting  Healthcare  Pharmaceuticals
 Business  Education  Human Resources  Telecommunications
 Communications  Engineering  Information Technology  Other: ___________________________

Highest level of education attained at the time of this application:

 High School Diploma / Global Equivalent  Bachelor’s Degree / Global Equivalent  Doctoral / Global Equivalent
 Associate’s Degree / Global Equivalent  Master’s Degree / Global Equivalent
Year diploma/degree was awarded: Name of High School, College or University:

Address: City: State/Province/Territory:

Country: Zip/Postal Code:

Field of Study:

 Communications  Engineering  Marketing  Science

 Computer Science  Finance  Mathematics  Other ___________________________
 Education  Liberal Arts  Pharmaceuticals
 PMI-SP® Certification Application
PAGE 3 OF 6 | EXPERIENCE VERIFICATION

Use the Experience Verification form to document at least 3,500 hours work experience in project scheduling if you hold a Bachelor’s degree/global
equivalent (within the past 5 years), or 5,000 hours work experience in project scheduling if you hold a high school degree (within past 5 years).

Number your projects and submit one set of Experience Verification Forms per project. Please copy these forms if you require additional space.

Project #: Project Title: Start Date (MM/YYYY): Completion Date (MM/YYYY):

Project Role: Project Industry:

Project Contributor --select one--
Job Title: Organization Name:

Organization Address: City: State/Province/Territory:

Country: Zip/Postal Code:

Phone (Country Code, Area/State/City Code, Phone Number): Extension:

Please identify and provide current information for your primary contact on this project so that PMI can verify your professional work experience.
First Name (given name): Last Name (family name, surname):

Contact Relationship:  Project Sponsor  Manager/Director  Client  Primary Stakeholder

Phone (Country Code, Area/State/City Code, Phone Number): Extension: E-mail:

For each project, please list the number of hours you have spent leading and directing the tasks noted in the five process groups. Next, add the total hours
per process and record that number in the boxes at the bottom of each section. Remember to record the project number that corresponds with the project
documented at the top of the Experience Verification form. Please ensure your description is between 50-80 words (300-500 characters).

Schedule Strategy:

Schedule Planning and

Development:

Schedule Monitoring
and Controlling:

Schedule Closeout:

Stakeholder Communication
Management:

Total Hours for Project:

0
 PMI-SP® Certification Application
PAGE 4 OF 6 | EDUCATION

Candidates holding a bachelor’s degree or global equivalent, document a minimum of 30 contact hours of education within the specialty area of project
scheduling. Candidates holding a high school diploma, associate’s degree or global equivalent, document a minimum of 40 contact hours of education
within the specialty area of project scheduling. One contact hour is equivalent to one actual hour of training or instruction received. There is no timeframe
associated with this requirement; therefore, candidates can document all education within the specialty area of project scheduling regardless of when it
was accrued. However, the course work must be complete at the time the application is submitted.

A. PMI Registered Education Providers (R.E.P.s)*

B. Courses or programs offered by PMI chapters or communities of practice*
C. Employer/company-sponsored programs
D. Training companies or consultants
E. Distance-learning companies,including an end of course assessment
F. University/college academic and continuing education programs

The following education does not satisfy the education requirements:

• PMI chapter meetings

• Self-study (e.g., reading books)
*Courses offered by PMI R.E.P.s, PMI chapters and communities of practice, or PMI, are pre-approved for contact hours in fulfillment of eligibility requirements.

 Course Title: Institute Name: Category (A-F):

Start Date (MM/DD/YYYY): Completion Date (MM/DD/YYYY): Hours: Qualifying Hours:

 Course Title: Institute Name: Category (A-F):

Start Date (MM/DD/YYYY): Completion Date (MM/DD/YYYY): Hours: Qualifying Hours:

 Course Title: Institute Name: Category (A-F):

Start Date (MM/DD/YYYY): Completion Date (MM/DD/YYYY): Hours: Qualifying Hours:

 Course Title: Institute Name: Category (A-F):

Start Date (MM/DD/YYYY): Completion Date (MM/DD/YYYY): Hours: Qualifying Hours:

 Course Title: Institute Name: Category (A-F):

Start Date (MM/DD/YYYY): Completion Date (MM/DD/YYYY): Hours: Qualifying Hours:

 PMI-SP® Certification Application
PAGE 5 OF 6 | GENERAL INFORMATION

Please include me in:

 Communications from PMI regarding its products,  Third Party Mailing Lists Mailings
events and services Mailings from organizations other than PMI

OPTIONAL INFORMATION
The following questions are optional, and you may choose not to answer them.

Reason you are applying for this certification:

 Employer Required  Employer Suggested  Personal Development

SPECIAL ACCOMODATIONS FOR EXAMINATION

 Check here if you have special needs which may impair your ability to take the examination. Please complete the Special Accommodations
Form. The completed form and supporting medical documentation must be returned to PMI along with your completed credential application.

 I have read and understand all the policies and procedures in the Certification Handbook.

 I have read and accept the terms and responsibilities outlined in the PMI Code of Ethics and Professional Conduct and in the PMI Certification
Application/Renewal Agreement.

 I declare that all the information I have provided on all pages of this application is true and accurate. I understand that misrepresentations or
incorrect information provided to PMI can result in disciplinary action(s), including suspension or revocation of my eligibility or certification.

 I understand that I must complete any coursework prior to sitting for the exam.

 I understand that I may be selected for audit at any time.

Signature Date

Certification application continues on the next page. Payment of the certification fee is expected to be received with the paper application.
To expedite processing, apply online at https://certification.pmi.org
 PMI-SP® Certification Application
PAGE 6 OF 6 | PAYMENT

Applicants are encouraged to apply using the online certification system, but may elect to pay the fees under separate cover.
Use this payment form to submit your fees by postal mail or submit payment through the online certification system.

PMI Member ID#: If you are a PMI member, you have an ID number. To find your ID number, log in to myPMI and select “Profile” from
the top navigation, then select “Membership Profile” from the left navigation. If you have any questions, you may
contact PMI Customer Care at +1 610-356-4600, or send an email to [email protected].

Prefix (Mr., Mrs., Ms., Dr.): First Name (given name): Middle Name:

Last Name (family name, surname). Candidates with only a single name should use last name field: Suffix:

PAYMENT OPTIONS
 Check  MasterCard  Visa  Bank Transfer  American Express  Diners Club  Discover
Credit Card #: Exp. Date:

Signature
EXAMINATION FEES Fees subject to change without notice.
After determining your membership status and your examination administration method, please check the box next to the appropriate option below
and note the associated fee in the box marked ‘TOTAL’.
If you are applying to take a paper-based examination please indicate your preferred test site, group testing number and date. This information can be
located at www.prometric.com/pmi. If you are unsure whether you should be applying for a Computer-Based Test or a Paper-Based Test, please refer
to your credential handbook for additional information.
U.S.
Examination Administration Type Dollars Euros

 Computer-Based Testing – member* US$520 €430

 Computer-Based Testing – nonmember US$670 €555

U.S.
Examination Administration Type Dollars Euros Site Group Testing No. Date (MM/DD/YY)

 Paper-Based Testing – member* US$415 €345

 Paper-Based Testing – nonmember US$565 €475

**Calculate and add Canadian resident tax (if applicable)

TOTAL

*The member rate will only apply to candidates who are members of PMI in good standing at the time your application is approved. If PMI membership is obtained
after this application has been submitted, PMI will not issue a refund. Candidates interested in becoming members of PMI at the time of application for the
credential can submit their PMI membership application and credential application at the same time and receive the member rate. To download a copy of the PMI
membership application, please visit the membership area of the PMI website.
**CANADIAN TAX INFORMATION
Canadian billing addresses: In accordance with Canadian tax law, taxes are collected on all certification-related products. The rate of tax varies depending on the
province billing address you use. Tax calculations by province are 15% for Nova Scotia, 13% for New Brunswick, Newfoundland/Labrador and Ontario; 14.975% for
Quebec, 12% for British Columbia and 5% for all remaining provinces. Online applications will automatically calculate tax. Downloaded applications will require
insertion of applicable tax. If your employer is paying for your membership and has been granted tax-exempt status by the appropriate Canadian authorities, you
will not be able to submit your application online. You will need to mail or fax your membership application along with a tax-exempt certification meeting the
specifications of the Canadian government.
GST/HST registration: 897944807RT0001; QST registration: 1202723001TQ0001
 Certification Examination
Special Accommodations Form

The PMI Certification Department complies with the Americans with Disabilities Act of 1990. To ensure equal opportunities for all qualified persons,
the Certification Department will make reasonable accommodations for candidates when appropriate. If you require special accommodations related
to a disability in order to take the examination, you must complete this form and submit it with your examination application (you can request special
accommodations through the online certification system when you apply online).

PMI Member ID#: If you are a PMI member, you have an ID number. To find your ID number, log in to myPMI and select “Profile” from the
top navigation, then select “Membership Profile” from the left navigation. If you have any questions, you may contact
PMI Customer Care at +1 610-356-4600, or send an email to [email protected].

First Name (given name): Middle Name:

Last Name (family name, surname). Candidates with only a single name should use last name field:

E-mail:

Which certification examination are you planning to take at this time?

 CAPM  PMP  PgMP  PMI-RMP  PMI-SP  PMI-ACP  PfMP

Please identify the disability that substantially limits one or more of your sensory, manual, or speaking skills (e.g., disability that significantly impairs
your ability to arrive at, read, or otherwise complete, the examination):

Please list the special testing accommodation requested. Use a separate sheet if more space is needed:

NOTE: You must provide PMI’s Certification Department with written documentation from an appropriate health care professional supporting the need for
the accommodation that you are requesting.This documentation must include a diagnosis of your health condition and a specific recommendation for the
type of special testing accommodations you will require. This completed form and supporting medical documentation must be submitted to PMI along with
your completed certification application. Failure to include supporting medical documentation will cause a delay in processing your application.
PMI will not pay any costs you may incur in obtaining this information.

Signature Date

PRA-234-2011(06-13)

PMI prefers that you apply using the online certification system at PMI.org
14 Campus Blvd | Newtown Square, PA 19073-3299 USA | Fax: +1 610 239 2257
 Certification Reexamination Form
Page 1 of 3

In order to schedule to retake a PMI examination, complete and submit this form by mail or fax to PMI Global Operations Center, Attn. Certification
Department. The reexamination rate is only valid within your one-year eligibility period. Before applying for reexamination, please review PMI’s
reexamination policy located in the handbook.

Please complete this form in its entirety in one of the following ways:
1. Print out the form and hand-write your information clearly in blue or black ink using ALL CAPITAL LETTERS.
2. Save the PDF to your desktop and open in Adobe Acrobat. Type in all your information, save the document, print it out and submit it.

PMI Member ID#: If you are a PMI member, you have an ID number. To find your ID number, log in to myPMI and select “Profile” from
the top navigation, then select “Membership Profile” from the left navigation. If you have any questions, you may
contact PMI Customer Care at +1 610-356-4600, or send an email to [email protected].

CONTACT INFORMATION
Please print your name as it appears on your government issued identification, that you will present at the testing center.

First Name (given name): Middle Name:

Last Name (family name, surname). Candidates with only a single name should use last name field:

Address: City: State/Province/Territory:

Country: Zip/Postal Code:

Preferred Email: Phone Number: Extension:

PAYMENT INFORMATION
 Check  Master Card  Visa  Bank Transfer  American Express Diners Club Discover
Credit Card #: Exp. Date:

Signature Date

REEXAMINATION FEES (Payable in U.S. Dollars and Euros only)

After determining your PMI membership status and your examination administration type, please place an ‘X’ next to the appropriate option and note
the associated fee in the box marked ‘TOTAL’ for the PMI examination you plan to retake (CAPM, PMP, PgMP, PMI-RMP, PMI-SP, PMI-ACP, or PfMP).
PMI uses computer-based testing (CBT) as the standard method of administration for its examinations. Candidates who live within 186.5
miles/300km of a Prometric CBT site, must take a CBT examination.
If you are applying to take a paper-based examination please indicate your preferred test site, group testing number and date. You can find this
information online at www.prometric.com/pmi.

CAPM Reexamination Administration Fees US Dollars Euros

Computer-Based Testing – member* $150 € 200 Group Date
Computer-Based Testing – nonmember $200 € 170 Site Testing No. (mm/dd/yy)
Paper-Based Testing – member* $150 € 125
Paper-Based Testing – nonmember $200 € 170

** Calculate and add Canadian resident tax (if applicable) TOTAL

PMI prefers that you apply using the online certification system at PMI.org PRA-233-2012(06-13)
 Certification Reexamination Form
Page 2 of 3

PMP Reexamination Administration Fees US Dollars Euros

Computer-Based Testing – member* $275 € 230 Group Date
Computer-Based Testing – nonmember $375 € 315 Site Testing No. (mm/dd/yy)
Paper-Based Testing – member* $150 € 125
Paper-Based Testing – nonmember $300 € 250

** Calculate and add Canadian resident tax (if applicable) TOTAL

PgMP Reexamination Administration Fees US Dollars Euros

Computer-Based Testing – member* $600 € 490 Group Date
Computer-Based Testing – nonmember $800 € 655 Site Testing No. (mm/dd/yy)
Paper-Based Testing – member* $500 € 410
Paper-Based Testing – nonmember $700 € 570

** Calculate and add Canadian resident tax (if applicable) TOTAL

PMI-SP Reexamination Administration Fees US Dollars Euros

Computer-Based Testing – member* $335 € 280 Group Date
Computer-Based Testing – nonmember $435 € 365 Site Testing No. (mm/dd/yy)
Paper-Based Testing – member* $270 € 225
Paper-Based Testing – nonmember $370 € 310

** Calculate and add Canadian resident tax (if applicable) TOTAL

PMI-RMP Reexamination Administration Fees US Dollars Euros

Computer-Based Testing – member* $335 € 280 Group Date
Computer-Based Testing – nonmember $435 € 365 Site Testing No. (mm/dd/yy)
Paper-Based Testing – member* $270 € 225
Paper-Based Testing – nonmember $370 € 310

** Calculate and add Canadian resident tax (if applicable) TOTAL

PMI-ACP Reexamination Administration Fees US Dollars Euros

Computer-Based Testing – member* $335 € 280 Group Date
Computer-Based Testing – nonmember $395 € 330 Site Testing No. (mm/dd/yy)
Paper-Based Testing – member* $285 € 240
Paper-Based Testing – nonmember $345 € 290

** Calculate and add Canadian resident tax (if applicable) TOTAL

PMI prefers that you apply using the online certification system at PMI.org
 Certification Reexamination Form
Page 3 of 3

PfMP Reexamination Administration Fees US Dollars Euros

Computer-Based Testing – member* $600 € 490 Group Date
Computer-Based Testing – nonmember $800 € 655 Site Testing No. (mm/dd/yy)
Paper-Based Testing – member* $500 € 410
Paper-Based Testing – nonmember $700 € 570

** Calculate and add Canadian resident tax (if applicable) TOTAL

* The member rate will only apply to candidates who are members of PMI in good standing at the time your application is approved. If PMI
membership is obtained after this application has been submitted, PMI will not refund the difference. Candidates interested in becoming members
of PMI at the time of application can submit their PMI membership application and the application at the same time and receive the member rate.
To download a copy of the PMI membership application, please visit the membership area of the PMI website.

**CANADIAN TAX INFORMATION

Canadian billing addresses: In accordance with Canadian tax law, PMI collects taxes on member dues, application fees, and other payments.
Canadian residents should include applicable taxes in the space provided. The rate of tax varies depending on the province billing address you use.
Tax calculations by province are 15% for Nova Scotia, 13% for New Brunswick, Newfoundland/ Labrador and Ontario; 14.975% for Quebec and 5%
for all remaining provinces. Online applications will automatically calculate tax. Downloaded applications will require insertion of applicable tax.
Please note that if your employer is paying for this purchase and has been granted tax-exempt status by the appropriate Canadian authorities, you
will not be able to use online processing. You will need to mail your application and mail or fax a tax-exempt document meeting the specifications
of the Canadian government to the PMI Global Operations Center (fax: +1 610-771-4085).

GST/HST registration: 897944807RT0001; QST registration: 1202723001TQ000

SPECIAL ACCOMMODATIONS FOR EXAMINATION

Candidates may request modification to the examination administration procedure due to disability, handicap, or other condition which may impair
the ability of the candidate to take the exam. To request special testing accommodation, candidates must indicate their need on this form by checking
the appropriate box below.

 I am requesting the same special accommodation(s) that was approved for my previous examination.
 I am requesting special accommodation(s) for the first time.
    (Please complete the Special Accommodations form separately and submit it to PMI with your reexamination form)

LANGUAGE AID FOR EXAMINATION

All PMI examinations are administered in English, but assistance for the CAPM and PMP can be provided with an accompanying language aid.
If you would like a language aid for the CAPM or PMP examination, please indicate your choice below.

 Arabic  Japanese
 Chinese (Simplified)  Korean
 Chinese (Traditional)  Portuguese (Brazilian)
 French  Russian
 German  Spanish
 Hebrew  Turkish
 Italian

PMI prefers that you apply using the online certification system at PMI.org