APICS CFPIM APPLICATION SUBMISSION CHECK LIST

Only complete applications will be submitted to the APICS CFPIM committee for review. The quality of your submission is likely to affect the acceptance or rejection of your application. Please review the following checklist and be sure that your application is complete and you have provided proper documentation for the items checked. Please see description for each activity and further description of required documentation at the end of the application.
Complete?

Item
Personal information is complete and legible Payment/credit card information has been provided I have maintained my APICS CPIM credentials to apply for APICS CFPIM designation Mandatory Letter of Recommendation from an APICS CFPIM is included

1. MANDATORY APICS CPIM EXAMS PASSED: Maximum of 75 points

I have earned my APICS CPIM Designation If designation was earned after 9/1/2000 required testing is complete. For the date APICS CPIM was earned, or exam dates and scores, please contact Certification@apics.org and the information will be provided If designation was earned before 9/1/2000 the CIRM designation is not also held or the recertification exam has not been successfully completed, the SMR exam will need to be passed to show currency in the APICS CPIM body of knowledge. Additional points earned by successfully completing the SMR exam can be added to exam points. Please see the APICS webpage for information on preparing and registering for the SMR exam.

Or

2. PRESENTATIONS: Maximum of 40 points

All presentations are between 30 minutes and two hours in length. All presentations have been completed within 3 years of application date. Required documentation is provided for all presentations. All presentations are clearly listed on the application, and all documentation is clearly matched to listing on the application. I have adjusted the number of points for the number of presenters All presentations were given outside of my regular employment All presentations are clearly within the APICS CPIM body of knowledge (BOK).

3. PUBLICATIONS: Maximum of 40 points

All publications were completed within 3 years of application date Required documentation is provided for all publications. If publications are not in English I have provided translations All publications are clearly listed on the application, and all documentation is clearly matched to listing on the application I have adjusted the number of points for the number of authors All publications are clearly within the APICS CPIM body of knowledge (BOK).

4. CLASSROOM INSTRUCTION: Maximum of 40 points

All instruction was completed within 3 years of application date Required documentation is provided for all instruction All instruction was completed outside of my regular employment All instruction was clearly within the APICS CPIM body of knowledge (BOK).

5. VOLUNTEER AND PRACTITIONER ACTIVITIES: Maximum of 20 points

All activities were completed within 3 years of application date Required documentation is provided for all activities

OVERVIEW PRIOR TO SUBMITTING APPLICATION

I have made a copy of my application and documentation prior to submitting them (Documentation will NOT be returned.) I have reviewed the date I received my APICS CPIM designation, and have completed the examination requirements to become an APICS CFPIM The application is signed Return your completed application package to: APICS The Association for Operations Management Certification Department Attention: APICS CFPIM Program 8430 West Bryn Mawr Avenue, Suite 1000 Chicago, Illinois 60631 USA You can email your completed and scanned application to certification@ apics.org. Email is not recognized as a secure medium of communication. For this reason we request that you use the fax form to fax your credit card information to us if you are using this option.

APICS will not confirm receipt of applications. Notification of status of applications will be sent 6 to 8 weeks after an application is received by APICS. If you do not receive a response from APICS after 8 weeks, please contact the certification department at (800) 444-2742 or (773) 867-1778, or email certification@apics.org Incomplete, non-conforming, or illegible applications will not be reviewed and refunds will not be provided Email addresses must be provided with all APICS CFPIM applications

APICS CFPIM APPLICATION

Application Please print clearly

FIRST NAME

M.I.

LAST NAME

LAST 4 DIGITS OF SOCIAL SECURITY NUMBER

DATE OF BIRTH

MONTH /

DAY

YEAR

CURRENT JOB TITLE

APICS member (check one)

Yes

No

APICS member / Customer ID number

Mailing address (check one)

Work

Home

COMPANY NAME (NOT REQUIRED IF YOU ARE PROVIDING YOUR HOME ADDRESS)

ADDRESS 1

ADDRESS 2

CITY

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

TELEPHONE

FAX

EMAIL

Payment information
The APICS CFPIM application processing fee is $30, application fee is non-refundable
Full payment must accompany this form.

Payment type (check one)

Charge to VISA American Express MasterCard Discover

ACCOUNT NUMBER

EXPIRATION DATE

NAME AS IT APPEARS ON CARD

SIGNATURE (REQUIRED FOR ALL CREDIT CARD PURCHASES)

Check number ________

Personal check

Company check

(Make check payable to APICS in US dollars drawn on a U.S. bank. Please include your APICS member/customer ID number on your check.)

Money order
Purchase orders and wire transfers will not be accepted.

Return your completed application, along with appropriate documentation and full payment to:
APICS The Association for Operations Management Certification Department Attn: APICS CFPIM Program 8430 West Bryn Mawr Avenue, Ste. 1000 Chicago, IL 60631 USA
You can email your completed and scanned application to certification@apics.org. Email is not a secure form of communication. APICS recommends that you do not send your credit card information via email.

FOR APICS USE ONLY Date received _______________ Payment received_______________

Credit card Check Date verified ________________ Money order

Page 1 of 2

APICS CFPIM APPLICATION (CONTINUED)

1. APICS CPIM EXAMS PASSED (Date you earned your APICS CPIM Designation __________________ If you earned your APICS CPIM designation prior to 9/1/2000 and you do not
hold either the CIRM designation or you have not successfully completed the Recertification Exam you will be required to take and successfully complete the SMR examination in order to attain the APICS CFPIM designation.

Title of APICS CPIM Exam

Scores of 319 or less, or scores of 84 or less prior to 9/1/2000 (5 points)

Scores of 320 or more, or scores of 85 or more prior to 9/1/2000 (15 points)

Category total (not to exceed 75 points) =

2. PRESENTATIONS: Please provide appropriate documentation. All activities must occur within 3 years of application.
Name of Event Sponsor Association Date of Event Unpublished (10 points) Published (20 points)

Category total (not to exceed 40 points) =

3. PUBLISHED WORKS: Please provide appropriate documentation. All activities must have occurred within 3 years of application
Title of Article/Work Publication Date Published Article (20 points) full book (40 points)

Category total (not to exceed 40 points) =

4. CLASSROOM INSTRUCTION: Please provide appropriate documentation. All activities must have occurred within 3 years of application
Name of Course Sponsoring Organization Date(s) Points (1 pt./hour of instruction)

Category total (not to exceed 40 points) =

5. VOLUNTEER AND PRACTITIONER ACTIVITIES: Please provide appropriate documentation. All activities must have occurred within 3 years of application
Name of Project APICS Committee Date(s) Points (10 points)

Category total (not to exceed 20 points) =

GRAND TOTAL (MUST BE AT LEAST 100 POINTS) =

In keeping with the APICS Code of Ethics, I hereby attest that all information presented on this application is correct and complete. I understand that I am responsible for submitting supporting documentation as evidence for points claimed. Furthermore I agree to abide by the rules and decisions of APICS and understand that falsification of this application is grounds for revoking certification.

SIGNATURE (REQUIRED)

DATE

NAME (PLEASE PRINT)

APICS MEMBER/CUSTOMER ID NUMBER Page 2 of 2

APICS CFPIM ACTIVITY CATEGORIES AND POINT ALLOCATION EXPLANATION 100 CONFORMING POINTS ARE REQUIRED FOR ACHIEVING FELLOW STATUS
1. APICS CPIM EXAMS PASSED MAXIMUM OF 75 POINTS
To assure currency in the APICS CPIM body of knowledge if your APICS CPIM designation was earned before 9/1/2000 and you have not either earned the APICS CIRM or CSCP designations or you have not successfully completed the recertification, you will need to successfully complete the SMR exam to show currency in the APICS CPIM body of knowledge. Additional points earned by successfully completing the SMR exam can be added to exam points. Please see the APICS webpage for information on preparing and registering for the SMR exam.

Required Documentation Earning points

None, exams and scores will be verified by APICS corporate office. Scores of 319 or less, or scores of 84 or less prior to 9/1/2000 earn 5 points. Scores of 320 or more, or scores of 85 or more prior to 9/1/2000 earn 15 points Points cannot be claimed for passing the APICS CSCP exam or exams take for other certification programs.

Ineligible activities

2. PRESENTATIONS MAXIMUM OF 40 POINTS

This category includes presentations that last for 30 minutes to 2 hours, such as presentations at conferences, professional development meetings, and workshops. All presentations must directly relate to the APICS CPIM body of knowledge and not be administrative in nature. Multiple presentations of the same material may be claimed as long as each was made to a separate eligible audience. If you were a co-presenter with one or more individuals or if you spoke as part of a panel discussion, you should divide the total points equally by the number of presenters and claim only the proper share. You may claim fractions of points. Webinars are considered presentations. As a general rule, activities that one does as part of their job or for hire are not eligible for points.

Required Documentation

For a presentation that has not been published, provide a copy of the announcement, brochure, flyer or newsletter that publicized the event. If the presentation was conducted for an organization, submit a letter from a manager on company letterhead attesting to your role. The announcement or letter must include the topic, date, and your name. For presentations that have been published, submit a copy of the published paper or article, or a copy of the cover, table of contents and first page. If publication is not in English a translation must be provided. Publications will not be returned.

Earning points
20 points are granted for published presentations from 30 minutes to 2 hours in length if they are made available to the general public. You must submit supporting documentation of the publication. PowerPoint slides, handouts and web pages or postings are not considered published works. 10 points are granted for unpublished presentations from 30 minutes to 2 hours in length

Ineligible activities

Presentations for which you were paid as a consultant, where you are promoting your own consulting practice or products and/or services are not eligible. Presentations given to employees of your own organization or to others as part of your normal duties are not eligible, as well as presentations not relevant to the APICS CPIM body of knowledge.

3. PUBLISHED WORKS MAXIMUM OF 40 POINTS

This category includes any article in the APICS magazine, the Production and Inventory Management Journal, the Journal of Operations Management, or an article relevant to the APICS CPIM body of knowledge published in another magazine or journal. Published works must relate directly to the APICS CPIM body of knowledge and must be authored by the applicant. Articles, books, white papers, scholarly research, and other works relating to production and inventory management that are specific to other countries are eligible. Business newspaper articles are eligible for points if they assist others in understanding the APICS CPIM body of knowledge, but the applicant must be the author of the article, not just quoted. In order to qualify for points, an article must be published in a magazine or journal with a large circulation and readership.

Required Documentation

Submit a copy of your article or published work, or a copy of the cover, table of contents, and first page. Publications will not be returned. If publication is not in English a translation must be provided. For larger published works, such as books, copies of the title page and table of contents must be provided in the original language with an English translation.

APICS CFPIM ACTIVITY CATEGORIES AND POINT ALLOCATION EXPLANATION 100 CONFORMING POINTS ARE REQUIRED FOR ACHIEVING FELLOW STATUS (CONTINUED)
Additional information on earning points
If you were a coauthor with one or more individuals, you should divide the points equally by the number of authors and claim only your share. Published material must be available to the public or distributed nationally or internationally. Effective January 1, 2011, APICS CFPIM points will be granted for virtual publications as long as materials are not self-published, i.e., they are peer reviewed and/or have editorial review. 20 points are granted for any published article, book chapter or other work directly related to the APICS body of knowledge where you are credited as the author. A doctoral dissertation on the APICS body of knowledge may be claimed for 20 points 40 points are granted if you are the author of a published book directed related to the APICS body of knowledge. 10 points are granted for a thesis on the APICS body of knowledge Articles published in chapter or regional newsletters are not eligible; nor are materials distributed via company newsletter or client publications. Conference proceeding articles should be claimed in the presentations category and cannot count for both. Papers written for a college course are not eligible because they have not been published, undergone peer review, and are not publicly available.

Earning points

Ineligible activities

4. CLASSROOM INSTRUCTION MAXIMUM OF 40 POINTS, NO MORE THAN 20 POINTS FOR NON-APICS SPONSORED COURSES
This category includes programs of education relevant to the APICS CPIM body of knowledge in which you led the classroom instruction and the program was longer than two hours. As a general rule, activities that one does as part of their job or for hire are not eligible for points. The primary exception is for teaching APICS CPIM certification review courses for which most instructors receive some stipend.

Required Documentation

Provide a copy of the announcement, brochure, flyer, or newsletter that publicized the event, or a letter signed by an appropriate official on the letterhead of the organization where the training was conducted. The letter must attest to your role and include the date(s) and hours of instruction and the names of the classes you taught. Points for educational programs that lasted fewer than two hours should be claimed in the presentations category. Classroom instruction can be provided for a fee, as long as the instruction covers the APICS body of knowledge and contributes to others understanding of such. Instruction can be APICS-sponsored courses,using teaching materials provided by APICS, or non-APICS courses, as long as the material is part of the APICS CPIM body of knowledge. One point is granted for each hour of instruction. If you shared the instructional duties, claim only those hours during which you delivered directly. You are not eligible for points in this category if the education you provided was as a service in a consulting or business capacity, or if it was provided for employees of your own company as part of your duties. Teaching by academicians in the course of employment or by graduate students to satisfy degree requirements is not eligible for points. Instruction done as a faculty member or visiting faculty is not eligible because it is done as part of your employment.

Additional information on earning points

Earning Points

Ineligible activities

5. VOLUNTEER AND PRACTITIONER ACTIVITIES MAXIMUM OF 20 POINTS

This section refers to activities in which the applicant has participated as a volunteer that contribute to others understanding of the APICS CPIM body of knowledge. For example, points may be claimed for service as a member of an APICS committee or as a subject matter expert for APICS headquarters, or for participation in an official APICS CPIM item-writing workshop, exam passing score study, or pilot program. Other activities that contribute to the expansion of the APICS CPIM program (such as courseware review) may be eligible. Contact APICS Certification Department at 1-800-444-2742 or +1-773-867-1777 for more information.

Required Documentation

On a separate sheet of paper, list the activity, including the date, location, chapter affiliation, and, if applicable, the exam or courseware module. A letter or certificate of participation is preferred documentation, alternatively a letter from the sponsor on letterhead can be submitted. For those outside of North America activities might include participation in a professional organization whose purpose is to advance education in production and inventory control or related subject areas. The activities claimed must be voluntary and contribute to others understanding of the APICS CPIM body of knowledge. Ten points are granted for each qualifying activity.
Serving on the local, regional, or national APICS board does not count unless the position is directly related to sharing the APICS CPIM body of knowledge (for example Vice President of Education). Administrative activities are not eligible to earn points.

Additional information on earning points

Earning points

Ineligible activities

Please note: Whenever documentation is not available in English translations must be provided.

8430 West Bryn Mawr Avenue Suite 1000 Chicago, IL 60631 USA Tel: 1-800-444-2742 +1-773-867-1777 Fax: +1-773-639-3000 apics.org

APICS CFPIM PAYMENT AUTHORIZATION FORM

Please use this form if you will be scanning your application and submitting your APICS CFPIM Application via email to certification@apics.org. Because you are being asked to provide your credit card information, you are strongly encouraged to fax this form for security purposes and to submit the remainder of your APICS CFPIM application as a scanned attachment to an email. Please note, there are significant documentation requirements for APICS CFPIM applications. Please remember to submit scanned documentation with your APICS CFPIM application. Please complete and sign this form, and fax to +1-773-639-3171. Please email scanned complete application and documentation to certification@apics.org.

Name:

APICS ID Number: All pricing and payments must be in USD. The APICS CFPIM application processing fee is $30. Payment Type (check one) Charge to VISA American Express Mastercard Discover

Account number

Expiration date

Name as it appears on card

Signature (Required for all credit card purchases)

If you are paying by check, please enclose your check with your completed APICS CFPIM application.

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