Read and follow these instructions. Incomplete applications will NOT be accepted. Completed applications will NOT be accepted after September 1, of the year in which the examination is given.
Fill in the information requested on this form.
The application fee for the Certifying Examination is $500.00.
Upon written request, received on or before August 1, in the year in which the exam is given, the application fee for the Certifying Examination is refundable (except for a $100.00 processing fee). The entire fee is forfeited after August 1.
This form includes:
Application for Certifying Examination
Statement of Completion of Resident Training Program
Honor Code Statement