Exam Purchase Order

Exam Purchase Order
Please allow a minimum of four weeks from the time we receive payment to candidate test date. Exam candidates will receive an email with instructions for setting up an online IBSC account, along with instructions for applying a voucher number to be used in lieu of payment. IMPORTANT: There will be a $100 fee for any changes to exam type or testing method after this form has been submitted to the IBSC office. No refunds or cancellations once Voucher number is assigned to exam candidate. Voucher numbers cannot be transferred to another exam candidate.
Date of Request

MonthDayYear
Date
Date of Exam

MonthDayYear
Date
Requestor Name
Company Name/Exam Host
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Email
example@example.com
Please fill out the quantities of each type of exam in the correct column. When this form is submitted, an invoice will be emailed to the address above.

Computer-based Exam (CBT)

Onsite Hosted Exam (Paper/Pencil or IBSC-MED )