Exam Invoice Request Form

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Upon receipt of this form, we will create an invoice and send it to the email listed below along with payment information.

Contact Information
Name of Organization to Invoice
Contact Person

First Name
Last Name

Organization Address

Street Address
Street Address 2
City	State/Province
Postal/Zip Code	Country

Email
Phone
Area CodePhone Number
Exam Information
Date
Month - Day - Year

Exam Location Address

Street Address
Street Address 2
City	State/Province
Postal/Zip Code	Country

Textbox
Exam Request

CMRP
CMRT
Location

Pearson VUE Testing Center
Number of Exams
Names of Exam Takers
Cost
If company IS NOT a Sustaining Supporter Organization (SSO):
- CMRP exam & SMRP membership 1-year: $470.00 USD
- CMRP exam & SMRP membership 3-years: $760.00 USD
- CMRT exam only: $300.00 USD
- CMRT exam & SMRP membership 1-year : $470.00 USD
If company IS a Sustaining Supporter Organization (SSO), or individual is active military or a U.S. Veteran:
- CMRP exam only: $250.00 USD each
- CMRT exam only: $195.00 USD each
- CMRP exam & SMRP membership 1-year: $420.00 USD each
- CMRT exam & SMRP membership 1-year: $365.00 USD each
If individual is a member of SMRP:
- CMRP exam only: $300.00 USD
- CMRT exam only: $250.00 USD
Number of exams x the cost for each exam = total USD:
Number of Exams
Cost of Each Exam
Number of Memberships
Cost of Each Membership
Total of Invoice
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