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Email:
Exam Date:
Please allow at least 5 business days notice for processing and proctor confirmation.
4 Hour Time Block:
Exam Location Time Zone:
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. You will be contacted via email to confirm exam logistics.

Proctor’s Name, If known at time of registration:    
Proctor’s E-Mail: 

Name:
Title:
Company:
Address:

City:    
State:  Zip:        
Country: 
Phone:    Fax:

Qualification Information:   Review the key qualifications
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)

Select Payment Type:

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              Expiration Date:    mm/yy
              First Name: 
              Last Name: 
         Billing address of cardholder:
               Street: 
               City: 
               State:    2 letter code
               Zip: 

         Registrations received without payment information will be processed as a payment pending status.
         If not submitting payment online, please print a copy of this form to mail or fax with your payment.
      

Please contact AAMA’s Education Coordinator if you should have any questions.