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Paper Credential Exam Registration Form

Paper Credential Exam Registration Form

This form is to request the paper CAAMA exam. 

IF THIS IS A RETAKE PLEASE CALL AAMA HEADQUARTERS AT
847-759-8601 OR EMAIL [email protected]
 

Entry Instructions: Use tab key or mouse to advance to next question.

DO NOT USE “ENTER” KEY UNTIL READY TO SUBMIT

Application/Registration can not be processed until payment is received.

Required fields are in red

Email:
Exam Date & Location:
Please allow at least 2 weeks notice for testing material production and mailing.
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 the time of registration:    
Proctor’s E-Mail:    


Name:
Title:
Company:
Address:
              
City:    
State:  Zip:        
Country: 
Phone:    Fax:

Qualification Information:   Review Key Qualifications
BS/BA Degree  
Graduate Degree/Degrees  
Years experience in a healthcare administration management position: 

Student Examinees (current enrollment):
Graduate Program  
College  

 
Exam Fee: $250 

Payment Information (required to process)

Select Payment Type:

Pay Now with Credit Card
               Enter information below:

              Credit Card: 
                       (Please enter numbers only. No separators.)
              Credit Card #:  
              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.