2003 December CFA® Exam Withdrawal Request Form

							                        2010 June CFA® Exam Withdrawal Request Form
Level I candidates currently registered for the 2010 June Level I exam may withdraw their registration.
The final deadline to submit a 2010 June Withdrawal Form is 28 May 2010 11:59 pm EST.
As a re-registering candidate, an additional enrollment fee is not necessary; however, all applicants are
required to pay a registration fee for each exam as determined by the CFA Program fee schedule. The
registration fee must be submitted at the time of registration. Candidates may be registered for only one
exam at any time. After you receive email confirmation of your withdrawal being processed, please visit
http://www.cfainstitute.org/cfaprog/register/index.html to register for an upcoming exam.
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I wish to withdraw from my 2010 June registration and understand there will be no refund of any fees. I
also understand that I cannot defer or carry forward or backward any registration fees already paid. Once
my registration has been withdrawn, should I wish to re-register for the original exam, I must submit
another application and registration fee according to the CFA Program fee schedule. Withdrawals will not
be reversed once processed.
Candidate Name: _____________________________________
                           Please print your name as shown on CFA Institute records

Candidate Number: _________________
Required. CFA Institute will not process this request without the six/seven-digit identification number

Email Address: _______________________________________________
Signature: _______________________________ Date: ____________
                                      Required

Important: If your address has changed, please note your new preferred mailing address below or
update your address through the CFA Institute website.

Preferred (please check one)                □    Business                    □   Home

New Address: ____________________________________________
             ____________________________________________
             ____________________________________________
Send completed form to:
Email: cmservices@cfainstitute.org
Fax: +1 (434) 951-5290

Mail: CFA Institute
Membership Department
PO Box 3668
Charlottesville, VA 22903-3668
Please keep a copy of your completed Withdrawal Request Form for your records. If mailing your form, to ensure
that your form can be tracked if not received, CFA Institute strongly suggests that you use an overnight courier.
CFA Institute is not responsible for lost shipments or mail that is not received by deadlines. It is the candidate’s
responsibility to ensure documents are received. Please note that we cannot confirm receipt of faxes. The fax
transmittal receipt is your confirmation that CFA Institute has received your request. Be sure to keep this receipt
for your records.
                  THIS FORM IS NOT INTENDED FOR EXAM CENTER CHANGE REQUESTS