Core Level Registration Application Form
- Those wishing to write the CRPA registration exam should note that the Core Level Registration application must be completed and postmarked no later than thirty (30) days prior to the scheduled exam date.
Personal and Professional Contact Information
- An application fee of $250 CDN is payable to the Canadian Radiation Protection Association. Note: 20% of this fee is non-refundable should you withdraw your application to write the registration examination. Receipts will be issued via email.
Credit Card Information
- I certify that all the information associated with this application is complete and correct to the best of my knowledge. I understand that any falsification in this application will be grounds for rejection, or later revocation of any certificate issued. I understand that the Canadian Radiation Protection Association (CRPA) may investigate any submitted information and I agree to provide additional documentation if asked. If I am registered with the CRPA at any level, I understand that I will be required to maintain the registration according to the conditions set by the CRPA. By signing this application I hereby release the CRPA, its administrators, volunteers, employees and all other persons associated with the CRPA, from any and all claims which have resulted or may in the future develop from any actions as a result of my practice of radiation safety. I am aware of the risks of practising radiation safety and hereby assume all risks known and unknown. I declare that these terms are fully understood and voluntarily accepted as part of this application process.
- ____ Current CRPA Membership Dues paid
____ Application Form completed and attached
____ Fee enclosed or indicated on application form ($250.00)
P.O. Box 83
Carleton Place, ON