CCP Certification Application

Please complete the application in full (include all required supporting documentation). Incomplete applications will not be processed.

Please have your ACA member number available when completing the application. If additional assistance is needed please contact the office of Membership Services at (703) 224-0115 or memberships@aca.org

If you have any questions or concerns regarding the application, please reach out to the Office of Professional Development via email: acaprodev@aca.org.
MEMBERSHIP STATUS
Are you currently a member of ACA?*

YesNo
Enter your Member ID here
PERSONAL INFORMATION
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Today's Date*

MonthDayYear
Date
Personal Email*
example@example.com
Work Email*
example@example.com
*Provide a copy of Agency or Government issued Photo Identification
File Upload*

Cancelof
EDUCATION
Highest level of education completed:*
Major/Area of Focus (Optional)
EMPLOYMENT INFORMATION
Type of Agency:*

Correctional InstitutionDetention Facility/JailCommunity Supervision
Type of Facility:*

AdultJuvenileFederal (Military/BOP)StateCity/CountyPrivateOther
Facility Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Phone*
Current Position*
Current Department
Total Full-Time Corrections Experience (Years in Service)*
Probationary Completed?*

YesNo
EXAM

Please select the certification exam you wish to take.*All examinees, except CCI examinees, must successfully complete the general CCP exam prior to any specialized exam.
Please select:*

CCP (ACA Member) - $100CCP (Non-ACA Member) - $160CCI-M (ACA Member) - $100CCI-M (Non-ACA Member) - $160
PAYMENT

Upon approval of an applicant’s certification application, the applicant will receive an approval email from the American Correctional Association. This email will contain a link directing you to the payment platform. Payment is due at the time of receipt. Following receipt of payment, you will receive a link on your invoice that will direct you to the scheduling options for the exam.
ACCOMMODATIONS & CANCELLATION
Americans with Disabilities Act:

If you wish to apply for special accommodations due to a disability, email Professional Development at acaprodev@aca.org
Cancellation Policy:

Examinations that are cancelled by the ACA due to severe weather and/or natural disaster and/or necessity as defined by ACA will be rescheduled as soon as possible, with no additional charges. In the event of such a cancellation, ACA shall not be held responsible for any expenses incurred by the applicant and shall not be required to return any fees paid by the applicant.

If an exam is scheduled for an applicant, but not administered on the scheduled date, due to the fault of that applicant, the applicant will forfeit the examination fee OR they may elect to reschedule their examination for a $25 rescheduling fee.

An applicant may retract an examination application if the Professional Development Department receives a written request. The request should detail the circumstances (e.g., no longer employed in corrections, promoted or demoted, etc.). A refund of the examination fee, less a $50 processing charge will be assessed.
SUPERVISOR INFORMATION
Supervisor's Name:*

First NameLast Name
Supervisor’s Telephone Number*
Supervisor Email:*
example@example.com
Supervisor's Title:*
Name of Facility:*
APPLICANT SIGNATURE DECLARATION

I certify that my answers are true and complete to the best of my knowledge. I understand that the submission of false or inaccurate information will result in the revocation of certification status.
Applicant’s Signature (Please Type)*
Signature*

Powered by Jotform SignClear
Today's Date*

MonthDayYear
Date
DO NOT COMPLETE - ACA USE ONLY
Reviewer
Review Date

MonthDayYear
Date
Date Received

MonthDayYear
Date
Test Date

MonthDayYear
Date
Verified By
Mail Date

MonthDayYear
Date
Expiration Date

MonthDayYear
Date
Should be Empty:

MEMBERSHIP STATUS

PERSONAL INFORMATION

EDUCATION

EMPLOYMENT INFORMATION

EXAM

PAYMENT

ACCOMMODATIONS & CANCELLATION

SUPERVISOR INFORMATION

APPLICANT SIGNATURE DECLARATION

DO NOT COMPLETE - ACA USE ONLY