Journey Level Recertification Examination

All exams are administered online. Results are provided at the completion of the examination.
Please check one:

Name:
SSN NITC ID #/ UA ID #:
Address:
City:
State:
Zip Code:
Telephone:
Email *:
The fee is $60.00 per recertification examination. Please make check or money order payable to NITC. Visa, MC or Amex are also accepted. Note: In some cases, payment is provided by the training agency or employer. Method of Payment must be included with form or call to pay by phone at (877) 457-6482. If payment is made by phone the form must be received via fax or email nitcjourneycerts@nationalitc.com beforehand.
Once payment has been received, you will receive an email from NITC within 2 to 3 business days with your online login information.
Signature:
Date: