Certification Test Application

Please allow at least 10 business days for course completion verification.

Once course completion has been verified, you will be mailed a letter, allowing you to test. It is required that you bring this letter with you to the testing center. Note: you must test within one year of your training completion date.

Be sure your mailing address is entered completely and accurately.

The fee to take the exam is $20 and must be paid by credit card to Ivy Tech prior to taking the exam.

Last Name
First Name
Middle Initial
Date of Birth
Zip Code
Daytime Phone Number
E-mail Address
If you have changed your name or moved within the past 5 years, please enter the information here.
Contact dementia-cert-app@lists.ivytech.edu for assistance.