Recertification Application

Certification Renewal Application

Please choose a certification to renew. IMPORTANT NOTE: All certifications with the same expiration date will be renewed. When submitting the renewal payment, you may only be able to select one certification in the system. If your certifications have different expiration dates, please contact us at info@captur.org for help.

Certification Program *

Certification Renewal *

Certification Renewal Fee - $ 100.00 Emeritus Status - $ 150.00

Please note: If you are applying for Emeritus status, this payment is only one part of the process. Please ensure you complete the other application steps, which are listed on the the Certification Renewal, Reinstatement, & CEUs page under the Become Certified menu above.

Total Amount

Account

Please enter a Username to create an account. If you already have an account please login before completing this form.

Username *

Check Availability
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Your Registration Info

IMPORTANT For certification exam registrations, the name you use to register for the exam must EXACTLY match the name on the government-issued photo ID that you will show to the proctor before taking the exam.

First Name *

Last Name *

Email Address *

Note: This email is where you will receive all testing-related communications.

Company Affiliate

(If applicable)

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *