Certification Candidacy Application

INSTRUCTIONS
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General Qualifications
This application is intended to be used by working professionals who feel they are prepared to sit for, and pass, the required
examination for the certification designation for which they are requesting candidacy.
It should be submitted by individuals who:
• Are working in the field covered by the certification designation,
• Have significant experience and breadth to have mastered the basics of the entire Common Body of Knowledge,
• Have reviewed the appropriate Common Body of Knowledge, and
• Are prepared to take the required examination and, therefore, desire to establish candidacy.
Do not submit the application if you:
• Are not yet working in the field but have an interest in obtaining employment in the field,
• Are working in limited areas of the field but would like to expand your work roles to include broader responsibilities,
• Are working in information technology but have only marginal involvement or duties related to the certification, or
• Are only interested in determining if this certification program will be of interest to you.
Fees in this program are nonrefundable and nontransferable. Candidates for certification who rely only on limited experience or too
few/specific study materials typically do not successfully obtain certification. Do not apply unless you feel confident that your work
activities and past experience have prepared you for the examination.

General Instructions
A. Applications must be mailed or faxed. Faxed applications will not be accepted if paying by check or money order. If
paying by check or money order, the required documents and fees must be mailed directly to:
Software Certifications, 2101 Park Center Dr., Suite 200, Orlando, FL 32835-7614 USA; Fax: 407-398-6817. If the
application is faxed, the applicant should retain the fax transmittal confirmation page in case there are any problems with
transmission and for verification that the documents were submitted prior to the deadline.
B. Application is for candidacy only. Processing and approval of this application by the administering body does not
confer certification upon the applicant. Upon acceptance of this application, the applicant becomes a candidate for
certification.
C. Applications must be timely. Applications must be completed, and all requirements met, at least 60 days before the
selected examination. Failure to meet this deadline will result in the candidate becoming ineligible for the selected
examination.
D. Applications must be legible. Handwritten applications are acceptable, but must be clearly legible so that the
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information contained is unmistakable. Note that handwriting degrades significantly when faxed.
E. Applications must be complete. If any information is missing or incomplete, payment will be processed, and the
applicant will be notified in writing of the missing/incomplete information. They will have 90 days to resubmit a complete
application, or the application will expire and the fees will be forfeited.
F. Correspondence must be in writing. To protect the integrity of the examination and certification processes, all
correspondence related to certification policies and procedures must be in writing, using e-mail, fax, or first class postal
service. Information and status obtained through telephone conversations with the administering body shall be
considered unofficial and off-the-record.
G. Length of application validity. All applicants have one year from the time candidacy is established in which to sit for the
initial exam, or the application expires and initial fees are forfeited. A second or third sitting, if required, must be
completed within 24 months of established candidacy through the examination retake process.

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 Certification Candidacy Application – Instructions (cont.)

Application Items
1. Certification. [Required] Circle the specific certification for which candidacy is being sought. Only one specific
certification is allowed for each application submitted. Candidates wishing to apply for more than one certification must
submit a separate application for each.
2. Candidate Name. [Required] Provide your full name: first name, middle initial, and last name; as it is intended to appear
on the final certification materials.
3. Home Address. [Required] Provide your home mailing address.
4. Employment Address. [Required] Employment information is required even if it will not be used for correspondence.
Employment in the field is required at the time of application submission. The month and year employment started must
be given.
5. Home vs. Employment. [Required] Choose which address (home or employment) you would like Software
Certifications to use for correspondence/shipping. Note: If the selected address is a postal box, all correspondence will
be sent via surface mail even in circumstances where the program would otherwise communicate using express services.
6. Contact Information. [Required] Provide this additional contact information to be used by Software Certifications to
contact you using a method other than postal mail. An e-mail address is required. If this information is not provided,
Program correspondence with the candidate is limited to first class postal mail. The candidate is responsible for
maintaining accurate information to ensure correspondence is received.
7. Application Fee Selection. [Required] Choose one of the two given options. Option A, for $350 US includes a CD of
the Study Guide. Option B, for $400 US, includes the CD and a hard copy of the Study Guide. Passing the examination is
not guaranteed based upon comprehension of the Study Guide alone.
8. Payment Method. [Required] Provide payment information for the selected option in Section 7, using either a check
payable to Software Certifications or a Credit Card. For security validation: If using a Credit Card, provide the V-code
from the back of the card. The V-code is the last three digits of the number printed on the signature strip on the back of
the card. Application fees are nonrefundable and nontransferable.
9. Exam Information. [Required]
a. Check 9A if you are currently undecided about which examination date/location is desired. Your location status will
be To Be Determined. If checked, an Examination Selection Form must be submitted to the administration body no
later than 60 days prior to the examination date chosen.
b. Check 9B to select an examination date and location from the Examination Schedule on our Web site. Provide the
exam date, location, and 5 digit code found on the Examination Schedule. Selecting an examination here does
not guarantee registration for this examination. Applications are processed on a first come, first served basis. If
the selected examination is full (candidates are notified in their confirmation letter), the choice will automatically
revert to 9A (To Be Determined) and an Examination Selection Form will have to be submitted by the candidate
selecting another examination sitting for a later date. Scheduled examinations are subject to change.
10. Eligibility Prerequisites. [Required] The candidate must meet one of the three eligibility prerequisites. Check one of
the three options and complete the corresponding information in sections 11 and 12, as necessary.
11. Educational Institution. [Required if 10A or 10B were checked] Provide information for the accredited school from
which a degree was received to satisfy the educational prerequisite for this certification program. The “Name Used” is
important if diplomas or transcripts used to verify this information will have a different name than the applicant’s current
name. Do not send supporting documentation unless it is requested by Software Certifications.
12. Previous Employer. [Required if 10B or 10C were checked and current employment period does not meet requirements]
Provide information for the period of employment that is being claimed to support the employment prerequisite for the
certification program. Entry can be omitted if the current employment listed in section #4 is sufficient to satisfy the
prerequisite. If filled in, the “Name Used” is important if employment records used to verify this information will have a
different name than the applicant’s current name. Use an additional sheet to provide other employment information if
needed to satisfy the required number of years.
13. Reference. [Required] Provide the name and contact information of an individual who can attest that you meet the
eligibility prerequisites and are currently working in the Information Services field. Note: The Candidate Character
Reference form is no longer required.
14. Candidate Signature & Date. [Required] This application must be signed and dated. Please read the text above the
signature block carefully before signing. Typed or printed names are not acceptable.

Important: To ensure eligibility for an examination, all candidacy requirements must be met at
least 60 days prior to the examination date.
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 Certification Candidacy Application

1. Certification: {circle one} CSQA CSTE

2. Candidate Name First Name Middle Initial Last Name

3. Home Address Street,

City State/Province Zip/Postal Code Country

4. Employment Address Company

Title/Job Division/Department

Street Mailstop

City State/Province Zip/Postal Code Country

Date Employment Started (Month/Year)

5. Which address should be used for certification correspondence/shipping? {circle one} HOME EMPLOYMENT

6. Contact Information Telephone Number

Fax Number

E-mail Address {Required}

7. Application Fee Selection ___ A. $350 US – Application fee + CD of the Study Guide.
{Check one}
___ B. $400 US – Application fee + CD + hard copy of the Study Guide.
8. Payment Method ___ A. US check or money order enclosed payable to Software Certifications. A receipt will be
{Check One} mailed with
___ B. Credit Card: MASTERCARD VISA AMEX {circle one and provide details} acceptance letter.

Card Number V-code Expiration Date

Cardholder’s Name

9. Exam Information ___ A. To Be Determined/Not yet selected {will submit Examination Selection Form at a later date}
___ B. Location and date from current examination schedule. {provide details below}

Exam Location

Exam Date

Exam 5-Digit Code

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 Certification Candidacy Application - Page 2

10. Eligibility Prerequisites ___ A. A baccalaureate degree (or equivalent) from an accredited college-level institution.
___ B. An associate degree and two (2) years experience in the information services field.
{Check one}
___ C. Six (6) years of experience in the information services field.

Name
11. Educational Institution
Street/Postal Box
Complete this section if
option 10A or 10B checked.
City State/Province Zip/Postal Code Country

Degree Attained Year Graduated

Name Used {If different from current name}

12. Previous Employer Company

Complete this section if Division/Department

Name Used {If different from current name}

13. Reference Name

All information in this section is Street Address

City State/Province Zip/Postal Code Country

Telephone Number

E-mail Address

In signing below, I certify that I am a working professional in the Information Services field covered by the certification for which I am applying. I
understand the Common Body of Knowledge and believe I am qualified to pass the required examination. I understand that the examination should not
be used as a diagnostic tool to evaluate skills and readiness, and that this certification is not intended to be used by novices attempting to enter the
profession.
I also certify that all information on this application is accurate. I understand that falsification of any kind may be considered cause for rejection,
withdrawal of certification, and forfeiture of all fees. I have read and agree to abide by and uphold the Software Certifications code of ethics. I
understand that only written correspondence is accepted for official questions related to my candidacy and subsequent certification. I understand the
recertification process and that failure to comply with it will result in loss of certification. I agree to allow Software Certifications to obtain necessary fees
through the payment information given above. I also give Software Certifications permission to release information concerning the status of my
certification once attained.
14. Candidate Signature Date

Incomplete or illegible applications will be returned to the applicant for correction.

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