Licensee Exam Registration

Name *

First

Last

Email *

Name of Individual Taking Exam *

Email Address of Individual Taking Exam *

Certification Type *

Select the applicable exam type from the list shown

Exam Type *

Select first exam if this is the first exam for this applicant. Select remedial exam if the applicant has already taken this exam in the past.

Total Amount

$0.00

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Exam Date *

Please select an available date

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