Send completed CFPS application to: For Internal Use Only

CFPS c/o NFPA Certification Dept. Date Postmarked:

1 Batterymarch Park, Quincy, MA 02169 Payment Rcvd:
(P) 617-984-7484 (F) 617-984-7127 New: Retest:
Email: [email protected] Meets eligibility criteria:
Web Page: www.nfpa.org/certification NFPA: CBT:_ Private:

CFPS Application (Page 1 of 2)

TYPE OR PRINT ALL INFORMATION - INCOMPLETE APPLICATIONS WILL BE RETURNED

Name: Email:
Home Address:
City: State: Zip: Home Phone:
PLEASE SELECT only ONE OF THE FOLLOWING CFPS EXAM OPTIONS

COMPUTER BASED TEST: The CFPS examination is available on demand as a computer-based test at
test assessment centers throughout the World. Upon receipt of the CFPS examination application and test
fee, the applicant will receive their authorization letter with instructions on how to schedule the computer-
based exam. A list of Computer-based test centers are located at the test administrators website at
www.isoqualitytesting.com.

PAPER AND PENCIL FORMAT the CFPS examination is offered in paper & pencil format from
8am-11am on the dates listed on the CFPS Webpage. Please submit application at least 4 weeks prior to test date.

2014 Exam Dates - Please indicate date/location choice. Visit www.nfpa.org/certification

for 2014 exam dates.

Date ______________________________________ Location __________________________________________

CURRENT EMPLOYMENT

Company Name: Dates of Employment: to present

Company Address:

City: State: Zip:

Business Phone: Mobile Phone:

Title and Job Description:

Field of Expertise:
Supervisor's Name (Print): Title:

I verify that is performing the duties and responsibilities as identified above.

Signature of Supervisor Date

1
Copyright National Fire Protection Association, Inc. All rights reserved. May not be reproduced without permission. This document
is controlled and has been released electronically. The version on the NFPA intranet is the up-to-date document. Hard copies are
uncontrolled and may not be up-to-date. Users of hard copies should confirm the revision by comparing it with the electronically
controlled version.
Certified Fire Protection Specialist Board Applicant & Certificate Holders Handbook Revised December 20, 2013
 CFPS Application (Page 2 of 2)

VERIFICATION OF ELIGIBILITY CRITERIA

Candidates must meet one of the following criteria to be eligible to take the CFPS examination.

1. High school diploma, plus six 2. Associates degree in engineering, 3. Bachelors degree in engineering,
years of verifiable work experienc technology or other related discipline technology, or other related discipline
dedicated to curtailing fire loss, from an accredited college or from an accredited college or
both physical and financial. university, plus four years verifiable university, plus two years of verifiable
Resume REQUIRED. work experience dedicated to work experience dedicated to
curtailing fire loss, both physical and curtailing fire loss, both physical and
financial. financial.
Copy of College Diploma or Copy of College Diploma or Transcript
Transcript AND Resume REQUIRED. AND Resume are REQUIRED.

The CFPS Practice Examination (Item # CFPSPE) can be purchased from NFPA Customer Sales at 800-344-
3555 or online at the NFPA Online Catalog at www.nfpa.org.

PAYMENT INFORMATION Certification Exam Fee: $350.00

Please Note: We DO NOT accept Purchase Orders
Amount Enclosed $

Check. (Please make checks payable to NFPA Certification Department)

Credit Card: MasterCard VISA Discover American Express

Credit Card # :_ Card Exp. Date:_

Name on Card: Signature:
Please Note: No shows forfeit all application fees.

AFFIRMATION AND AUTHORIZATION: I agree to inform and release to the CFPS or its agents all
pertinent information related to situations that arise in connection with my application and/or certification, both now
and in the future. I understand the CFPS reserves the right to verify any and all information in this application or in
connection with my certification. Therefore, I understand and agree that my failure to provide accurate, true and
correct information, respond to authorized CFPS requests for additional information, or abide by CFPS policies,
procedures or Code of Ethics shall constitute grounds for rejection of my application or denial or revocation of my
certification. I understand the demographic information provided on this application is confidential and will be used
for aggregate purposes only. I understand that I am prohibited from transmitting information regarding examination
questions or content in any form to any person or entity, and understand that failure to comply with this prohibition
may result in my certification being revoked and/or legal action being taken against me. I understand that my name,
address and contact information will become part of the registry of the CFPS upon successful completion of the
examination, unless I specifically request that my name not be released. I acknowledge and agree that the CFPS Board
and NFPA shall have the right to revoke or invalidate any examination score, with or without a finding of fault or
misconduct on my part, if data forensic analysis or other credible evidence establishes a reasonable possibility that a
score is not valid or that the integrity or security of the examination was compromised.

(Signature) (Date)

2
Copyright National Fire Protection Association, Inc. All rights reserved. May not be reproduced without permission. This document
is controlled and has been released electronically. The version on the NFPA intranet is the up-to-date document. Hard copies are
uncontrolled and may not be up-to-date. Users of hard copies should confirm the revision by comparing it with the electronically
controlled version.
Certified Fire Protection Specialist Board Applicant & Certificate Holders Handbook Revised December 20, 2013
 3
Copyright National Fire Protection Association, Inc. All rights reserved. May not be reproduced without permission. This document
is controlled and has been released electronically. The version on the NFPA intranet is the up-to-date document. Hard copies are
uncontrolled and may not be up-to-date. Users of hard copies should confirm the revision by comparing it with the electronically
controlled version.
Certified Fire Protection Specialist Board Applicant & Certificate Holders Handbook Revised December 20, 2013