NOTE: A REQUEST FOR REINSTATEMENT MUST BE SUBMITTED FOR EACH CERTIFICATION SUSPENDED OR REVOKED.
This form is for use by Regular Certified Members ONLY. Other member categories should email firstname.lastname@example.org for instructions.
Fees Due: $100 Reinstatement Fee + $150 Annual Member Fee
Total Due: $250 (each certification reinstated)
For your convenience, Autofill will keep all your input data for 24 hours if you must leave the form before completing. You must use the same browser in order to pick up the form where you left off!