BEAC Examination Registration

Board of Environmental, Health & Safety Auditor Certifications

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CERTIFICATION
Examination Registration

WHICH EXAMINATION ARE YOU REGISTERING FOR?

Environmental Compliance - application for certification has been submitted
Health & Safety - application for certification has been submitted
Management System - application for certification has been submitted
Responsible Care® - application for certification has been submitted
Responsible Care® - no application, Certificate of Attainment for Exam only (fee is $600)

EXAM DATE AND LOCATION
ONLINE?	You will be contacted via the email address you provide below to set up the online test location and date.
OR	Per group testing schedule
DATE:
LOCATION:

Last Name:
First Name:
Company:
Title:
Address:
City:
State/Province:
Zip:
Country:
Phone:
Fax:
E-mail:

Note: a discounted rate per exam part is available for members of The Auditing Roundtable (AR) and/or The Institute of Internal Auditors (IIA)

EXAM PARTS
		Regular	AR / IIA member	Reschedule fee
	Part 1	$150	$120	$100
	Part 2	$150	$120	$100
	Part 3	$150	$120	$100
	RC Exam only	$600
TOTAL EXAM FEES

PAYMENT OPTIONS:
	CHECK, payable to BEAC (in US Dollars). For checks drawn on banks outside the U.S. and Canada, add $30 bank collection charge. For wire transfers, add $40 transfer free.
	Credit Card Payment

CREDIT CARD Information:
	Credit Card Type:
	Credit Card Number:
	Expiration:	/
	Card Holder's Name:

Please note that the information you send about your credit card is e-mailed directly to BEAC. This information is NOT encrypted. If you are concerned about this, please print this form and fax it to: 407-830-7495

Cancellation Policy: If you are unable to take the exam as scheduled at an ACT test center, you must notify them 48 hours in advance, otherwise you will be charged a penalty for rescheduling.

By submitting this registration, you agree to the following:

I ACKNOWLEDGE THAT THE BEAC EXAMINATION COMPRISES PROPRIETARY INFORMATION, AND DISCLOSURE OF ANY MATERIAL IN THIS EXAMINATION WOULD BE IN VIOLATION OF THE BEAC CODE OF ETHICS

Comments:

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