Application for the Credit Business Associate
SM
(CBA
SM
) Designation
Applicant Information
Mr./Ms. First Name Middle or Maiden Name Last Name
Title Business Email Address
Company
Business Mailing Address
City State/Province Zip/Postal Code Country
Business Shipping Address
City State/ Province Zip/Postal Code Country
Direct Business Telephone Main Business Telephone
Home Address
City State/ Province Zip/Postal Code Country
Home Telephone Personal Email Address
Birth Month/Day (MM/DD) __________ The name of my local NACM Affiliated Association: _______________________________________
I understand that I must already be registered with the National Education Department. (If you are not already registered, please attach a
registration form, with the appropriate fee, to this form.)
I understand that a non-refundable fee must accompany this application. This fee covers the CBA
SM
designation process. I further understand
that should I fail to complete this process by not taking the exam within one year of my written approval, I will need to reapply. The application
fee is not divisible; no part will be refunded should I not complete the process.
Application Fee: ☐ Member: $270 ☐ Non-member: $540
☐ A check, made payable to NACM-National Education Department, is attached.
Charge to: ☐ VISA ☐ MasterCard ☐ American Express ☐ Discover Card
Card Number Card Security Code Expiration Date
Cardholder’s Name Cardholder’s Signature
Credit Card Billing Address
Please send all correspondence related to this application to:
☐ Home address ☐ Business address
I plan to sit for the CBA
SM
exam on the following date:
☐ March 4, 2024 (paperwork deadline: January 12)
☐ June 9, 2024 exam given at NACM’s Credit Congress in
Las Vegas, NV (paperwork deadline: April 19)
☐ July 22, 2024 (paperwork deadline: May 31)
☐ November 4, 2024 (paperwork deadline: September 13)
☐ March 3, 2025 (paperwork deadline: January 10)
☐ May 18, 2025 exam given at NACM’s Credit Congress in
Cleveland, OH (paperwork deadline: April 4)
☐ July 21, 2025 (paperwork deadline: May 30)
☐ November 3, 2025 (paperwork deadline: September 12)
Professional Certification Program 1 of 3
Application for the Credit Business Associate
SM
(CBA
SM
) Designation
Required Course Work:
Please indicate how you completed each course by checking the applicable box and providing any additional information
requested below:
Basic Financial Accounting
☐ NACM-National’s online accounting course. Indicate final grade and dates of attendance.
☐ NACM Affiliated Association sponsored course. Indicate name of NACM Affiliate and date course was completed. Attach end of
course certificate or grade report.
☐ College course. Record the institution where the course was taken. Official transcripts must be sent by the college or university
to the NACM-National Education Department. Courses must be taken at degree-granting institutions only.
Financial Statement Analysis 1
☐ NACM-National’s online Credit Learning Center course.
☐ NACM-National’s Certificate Session course taken at NACM’s National Headquarters. Indicate dates of attendance.
☐ NACM Affiliated Association sponsored course. Indicate name of NACM Affiliate and date course was completed. Attach end of
course certificate or grade report.
☐ College course. Record the institution where the course was taken. Official transcripts must be sent by the college or university
to the NACM-National Education Department. Courses must be taken at degree-granting institutions only.
☐ Other applicable Financial Analysis 1 course.
Business Credit Principles
☐ NACM-National’s online Credit Learning Center course.
☐ NACM-National’s Certificate Session course taken at NACM’s National Headquarters or NACM’s Credit Congress.
Indicate dates of attendance.
☐ NACM Affiliated Association sponsored course. Indicate name of NACM Affiliate and date course was completed. Attach end of
course certificate or grade report.
Professional Certification Program 2 of 3
Application for the Credit Business Associate
SM
(CBA
SM
) Designation
Testing Location
The exam will be given at your local affiliated association office unless special, advanced arrangements are made. If you wish to test
at a location different from your affiliate office (must be approved by NACM), please provide proctor information below. Proctors
must be in a supervisory role or a human resource representative from your company.
Proctor Name
Proctor Title
Shipping Address (street address only)
Email Phone
☐ Check here if upon receiving the CBA
SM
designation, you would like NACM to notify your immediate supervisor (only one name
please) of your achievement. The NACM president should send the notification to:
Mr./Ms. Name of Supervisor Supervisor’s Title
Company
Mailing Address
City State/Province Zip/Postal Code Country
Direct Phone Email Address
I hereby apply for admission to the Credit Business Associate
SM
(CBA
SM
) Designation.
I understand that I must take and pass the CBA
SM
exam before achieving this designation.
I have met all of the requirements for this designation as outlined in the NACM Professional Certification brochure. By my signature,
I agree to uphold the NACM Canons of Business Credit Ethics with the knowledge that any false statement or misrepresentation
that I make in the course of these proceedings may result in the revocation of this application, forfeiture of the application fee and
prohibit me from participating in the Professional Certification Program. I further agree to conduct myself in all business dealings
so as to reflect honor and merit upon the financial and business credit profession.
Signature of Applicant Date
I understand that by providing my mailing address, email address and telephone number, I consent to receive communications
sent by or on behalf of the National Association of Credit Management (NACM), FCIB-NACM, Inc., and its subsidiaries and
Affiliated organizations, via regular mail, email or telephone.
Signature of Applicant Date
☐ Check here to opt out of the congratulatory listing published in
Business Credit
magazine.
Return completed form to:
NACM Education Dept., 8840 Columbia 100 Parkway, Columbia, MD 21045-2158 • Fax: 410-740-5574 • Email: [email protected]
Professional Certification Program 3 of 3
