STEP1:
CICS  Certification, Certification Re-test, and
CICS /CICP Certification Application
This Application is for:



Re-certification Application
CICP Certification Application
Name:
First: M.I. Last: Suffix:
Email:
Business Address:
Company: Bus Phone:
Address: Country:
City: State: Zip:
Home Address:
Address: Home Phone:
City: State: Zip:
Date of Birth:
Send Mail To:



For Re-certification skip to: Re-certification Summary

For CICS Certification Re-testing please enter your A- application number
Certification Continuation
College Education (Business Administration, Industrial Engineering or Equivalent)
Name of College/University
City, State
Attendance
Major
Year of Graduation
Degree Received
From
To
Internal Control Design and/or Assessment work experience
Dates of Employment
From (Mo. Year) to (Mo. Year)
Name of Employer
Address
Position Title/
Rank/ Grade
Total Years in this Assignment
Number of Personnel at all Locations Under Your Supervision
Name & Title of Immediate Supervisor
Internal Control Work Activities
 for Certification/ Re-testing Applicants -go to [top of application form] or
[Professional Code of Conduct]
CICS/CICP RE-CERTIFICATION SUMMARY FORM
(fill out ONLY if you are applying for re-certification)
Certification: Certification #: Expiration Date:
Current Job Title/Description:
Reporting Categories
Sponsor's Organization Name/Location

Reporting Yr 1
Dates:
from     /   to
-

Reporting Yr 2
Dates:
from    /    to
-
Reporting Yr 3
Dates:
from     /    to
-
 
Activity
Description/Date
#of Credits
Activity
Description/Date
#of Credits
Activity
Description/Date
#of Credits
A. Education
(training attended)

B. Publications
(Papers / articles published)
C. Teaching / Presentation
(speaking engagements)
D. Professional Participation
(Meetings / conferences)
E. Other (identify category)
(additional activity space)
F. Other (identify category)
(additional activity space)
G. Other (identify category)
(additional activity space)
Reporting Year Totals
---
---
 
3-Year Grand Total
---
Additional Comments (if necessary)
 
Additional information required for CICP certification
Job Experience & Skill Proficiency Support
(A minimum of 6 skills required; 1 Mandatory; 5 optional)
JOB DIMENSION
PROOF OF SKILL PROFICIENCY

Internal
Control
Concepts
(Mandatory)
2
Internal Control
Environment
3
Risk
Management
4
Assessing Application
Controls
5
Business System
Control Assessment
6
Risk
Assessment
7
Internal Control
Measurements and
Reporting
8
Governance
Practices
In making this application, I certify that all information (including any attachments submitted) is accurate to the best of my knowledge, and that any false entry may be considered sufficient cause for rejection or withdrawal of certification, and forfeiture of fee. I have read, and subscribe to, the Professional Code of Conduct.

Submission Checklist

  Have you icluded your Internal Cotrol Specialty job description?

  Have you included your Internal Control process or Activity plan?

  Have you asked a client or manager to write your job experience attestation letter?

List current CICS No.
STEP2:
The Professional Code of Conduct
The Professional Code of Conduct is designed to promote and maintain the highest standards of performance and personal conduct among Certified Internal Control Specialists and Professionals. The code requires that Certified Internal Control Specialists and Professionals will:
• Maintain and improve their professional competency through
continuing study.
• Cooperate in the development and interchange of knowledge
for mutual professional benefit.
• Maintain high personal standards of moral responsibility, character, and business integrity.
 
In making this application (Certification, Certification re-testing, Re-Certification), I certify that all information (including any attachments submitted) is accurate to the best of my knowledge, and that any false entry may be considered sufficient cause for rejection or withdrawal of certification, and forfeiture of fee. I have read, and subscribe to, the Professional Code of Conduct.



STEP3:
Payment
CICS Certification Fee is $300 USD; CICP Certification Fee is $400 USD; Re-testing $75 USD per re-test; and $100 USD for 3-year CICS/CICP re-certification period. You may choose to pay online or pay by check. Certification application will not be processed until payment is received.
Shipment type:

Payment method:

Payment method is required to complete your certification application. If "Invoice" is selected, a P.O. Number is required for the application to be processed. Invoice orders submitted without a P.O. Number will be invoiced ONLY and the application will be processed when the payment is received.

P.O. Number:  

Secure online credit card processing payment:
Card Type: 
Card #: 
Expiration Date: 
Card ID Number: 
 
Amount Charged: 
Cardholder's Name: 
Billing Address: 
Comments, Questions, Other: 

 
After clicking submit you will be directed to a Thank You page containing the information submitted. A confirmation email that your application and payment are being processed.