Credentialing Exam Registration Form

Credentialing Exam Registration Form

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Payment is required with registration.

Email:
Exam Date & Location:
You may take the exam at your location provided the person you choose as your proctor holds the CAAMA designation or is part of a Human Resource or Education/Training Department. Please contact AAMA’s Education Coordinator if you should have any questions.
Name:
Title:
Company:
Address:
City:    State:
Zip:         Country:
Phone:    Fax:
Qualification Information:
BS/BA Degree
Graduate Degree/Degrees
Years experience in a healthcare administration management position:
Student Examinees (current enrollment):
Graduate Program
College
Payment Information (required to process)
Exam Fee: $250.00
Is this a retake?  Yes  No (2 retakes at no charge)
Payment Method?  Visa  MC  AmEx  Discover
Credit Card # Expiration Date:
You will receive a confirmation by mail within 2 weeks.