I hereby attest that I am a member of TheIIC in good standing. I hereby request that my certification be changed as per my selections below:
**Important- Change date DOES NOT affect the renewal date! Your renewal date will remain the same.
I hereby request a replacement certificate and a new membership card reflecting the change in my certification and agree to pay the $50.00 Change of Certification Fee upon submission of this form. Payment will be via Credit Card through Paypal.