CHRP EXAMINATION REGISTRATION FORM The Certified Human Resources Professional (CHRP) designation is a national standard administered by the provincial human resources associations who are CCHRA members. This registration form is for provincial association members who wish to register for the National Knowledge Exam™ (NKE). You must be a member of your provincial association to register for this exam. Enrollment is through your provincial office. The NKE is offered in June and November of every year. Eligibility to write the National Knowledge Exam™ is determined by each provincial association. Registration deadlines are available at: http://www.chrp.ca/?page=Exam_Dates Member ID # Membership Category (to be completed by provincial HR association office) MEMBERSHIP INFORMATION Prefix First Name Title Initial Last Name Organization Preferred Mailing Address: This address is for: Work Province/State City Home Postal Code Fax Telephone Email EXAMINATION TO BE WRITTEN (offered in June and November every year) Note: You must bring photo ID and your CCHRA confirmation letter with you for admittance to the examination The CCHRA & HRMA reserve the right to make changes to the exam process and format at any time up to 7 days prior to the examination date. Please select the exam you wish to write: June 4, 2016 National Knowledge Exam™ I will write in: English French November 5, 2016 Special Needs As of January 1, 2011, a minimum of a bachelor's degree from an accredited college or university is required in order to qualify for the CHRP designation. CHRP Examination Registration Form Page 2 FEES (Pre-payment required) $400.00 + 20.00 GST = $420.00 National Knowledge Exam™ Please note: Once the registration deadline has passed, examination fees are non-refundable. If you have not already paid the application fee of $60 + GST, it will be automatically charged to you when you register. If you are sitting the exam outside of Canada, you are not subject to the GST. Please subtract the GST from your fees. METHOD OF PAYMENT: Visa MasterCard AMEX GST/HST #119446714 I hereby give HRMA authorization to charge my credit card the amount indicated above for my exam registration and the application fee, if not previously paid. In the event that my credit card is declined for any reason, I understand that I will be charged an additional processing fee of $30.00 Card # Name on Card Expiry Date Signature OR Cheque/Money Order # A $30.00 administration fee will be charged on NSF cheques. DECLARATION I hereby register for the National Knowledge Exam™. I have read and agree to abide by the National Code of Ethics: http://www.chrp.ca/?page=Code_of_Ethics I understand that: 1. If I wish to defer writing an exam, I must submit a deferral application form to CHRP@hrma.ca 2. If my application for deferral is approved, I will be registered for the next exam sitting. A maximum of two deferrals per exam are possible. 3. Up to 30 days before the exam date, I may defer without a deferral fee. 4. Between 30 and 7 days prior to the exam date, I may defer to the next sitting but will be charged a deferral fee of $100 + GST, except in cases of illness or bereavement (official verification required). 5. Within 7 calendar days of the exam date, deferrals are not allowed unless there is verified proof of extenuating circumstances such as serious illness or loss of immediate family member. I must contact my provincial human resources association as soon as possible should such a situation arise. 6. My provincial human resources association will review the application and determine whether I qualify based on illness, bereavement or other special circumstances. 7. Cancellations within 7 calendar days of the exam date for any other reason are considered to be noshows and the full exam fee will be forfeited. 8. Registrants who defer to a future sitting and then cancel their registration any time prior to this sitting will forfeit their initial exam fee plus any deferral fee paid. 9. Membership fees are non-refundable. Signature Date Privacy Notice: The CCHRA and HRMA collect and use the information you have provided for exam administration and registration purposes only, including the verification of your qualifications and exam deferral circumstances as required. If you have any questions regarding our use of your personal information, please contact the CCHRA at 1-866-560-1288 or HRMA at CHRP@hrma.ca. HRMA's privacy policy is available at: http://www.hrma.ca/about-hrma/governance/policies/personal-privacy-protection Please forward your completed application and exam fees to: HRMA, 1101-1111 West Hastings Street, Vancouver, BC V6E 2J3 Fax: (604) 684-3225 Email: CHRP@hrma.ca Print Form