Payments & Certification Renewal

Name:_____________________________________________________________________

Title:____________________________ Company:_________________________________

Address:___________________________________________________________________

___________________________________________________________________________
                                                                      country                       postal code

Telephone: ______________________________       Fax: __________________________ 
                   (country code)+(city code)+number        (country code)+(city code)+number

Email: ___________________________       Website: _____________________________

Check Enclosed (make payable to ICC International)        Amount: ___________________

____ MasterCard ____ VISA (Sorry, we cannot accept American Express)

Credit Card Number

Card Expiration Date: _________   Signature (Required): ___________________________

____ Good standing in ACP International
____ Employee of ACF Member firm
____ Not affiliated with ACP International or ACF

Application and Renewal Fees

Associate

Practitioner

Fellow

Emeritus

$75

$115

$175

$75

Professional Courtesy

• ACF Member
• ACP International Member
• IAEVG Member
• ICG Member

$50

$75

$125

$50

Portfolio Fees

Associate

Practitioner

Fellow

Emeritus

$150

$250

$345

$50

Professional Courtesy

• ACF Member
• ACP International Member
• IAEVG Member
• ICG Member

$100

$200

$285

$0

Portfolio Upgrade Fees

Associate to Practitioner

Practitioner to Fellow

Standard

$100

$50

Professional Courtesy

• ACF Member
• ACP International Member
• IAEVG Member
• ICG Member

$100

$50

Declaration: I have read the qualifications for the type of ICC International certification indicated above and believe that I meet the qualifications detailed in the ICC International Categories.

Signature:________________________________________________________

Application and Portfolio Fees are due at the time your Portfolio is submitted.  If your Certification is not accepted, the Application Fee will be refunded. The Portfolio Fee is non-refundable.

Annual Renewal Fees are due on the anniversary of becoming Certified and you will be invoiced.

For Re-certification (every three years), there is no additional fee. You pay only the annual renewal fee.

Certification in ICC International will not take place, or be continued without receipt of the Application, Portfolio and/or annual fees when they are due.