Registration for Project Management Certification
Application for first-time certification (submit 1 copy to the VZPM) Certified Project Management Associate IPMA Level D
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Examination date: Personal details: Salutation Title: Name: First name: Address: Post code: Place: Country: Telephone – home: Telephone – mobile: Telephone – work: E-mail address – home: E-mail address – work: Date of birth: Nationality: Place of origin (CH citizens)
Send invoice to: Home address Employer Other (please enter billing address below) Billing address: Address: Additional address information Postcode, town: Contact person other information Member of the following sponsoring organizations (insert membership no.): Candidate: SGO ASO/ASIO SPM SMP Company / training institute: SGO ASO/ASIO SPM SMP Language (please tick one in each row) Certification process language Certificate language Current professional status Employee Self-employed Student* Unemployed* * Please attach ID/proof (in accordance with tariff scale) German German French French English English membership no. membership no. membership no. membership no. membership no. membership no. membership no. membership no.
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Admission For admission to the written examination for Certified Project Management Associate IPMA Level D, the admission conditions set out in Art. 4 of the Guideline for certification as a 'Certified Project Management Associate IPMA Level D’ must be met. The 'Proof of Admission' form must be enclosed with this application along with the necessary copies. The self assessment must be completed and enclosed with this application. The certification application must be rejected if the 'Proof of Admission' form and the completed self assessment have not been enclosed or have not been completed truthfully and in full. Declaration by applicant I am aware that certification, once awarded, is published and entered in a list available to the public; my address data are made available to the sponsoring organizations; the VZPM must be notified of any address changes immediately; certification by the VZPM is subject to fees and that these fees have to be paid even if I withdraw from the certification process or fail to achieve certification; the certificate remains the property of the certification office and that only the certification office may use the certification logo.
Furthermore, I declare that I have studied in depth the Certification Regulations and all the applicable documents about the certification process, and in particular the rights and regulations it involves. I accept these conditions and affirm that all the details I have provided are true. Signature of applicant
Candidate’s signature: Place Date: Stamp and signature of company/school (where invoice is billed to company/school)
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Proof of Admission to the examination "Certified Project Management Associate IPMA Level D" Name / First name: Conditions for admission in accordance with Art. 4 of the Guideline on Certification as 'Certified Project Management Associate IPMA level D’ On registration, written evidence must be provided showing that the candidate has worked on projects in specific project management areas for approximately one year. Candidates must have completed an apprenticeship as the minimum training requirement. Proof of admission I meet the conditions in accordance with Art. 4 of the Guideline on Certification as 'Certified Project Management Associate IPMA level D’. Secondary school or higher qualifications (description): Vocational apprenticeship completed as: Project management experience Employer/ client Duration of activity
from (YYYY/MM) to (YYYY/MM)
Type of activity
Self-assessment Copies of training Student ID / proof of unemployment
a) By signing below, the candidate confirms that he has completed this "Proof of Admission" form fully and truthfully.
Candidate’s signature: Place : Date:
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