IPMA Level –certificate application form

A.Personal data

Notice! First name and surname will be displayed on the certificate. Certificate will be sent to home address.

Surname / First name
Email address / Telephone number
Home address / Date andplace of birth
Postal code and city/province / Gender
MaleFemale
Education

B.Company data

Company name
Post address

C.Invoicing data (Remember to check that your invoicing address is correct!)

Company name
Invoicing address

OR

e-invoice address (EDI, OVT or IBAN code) / Service providers operator code for e-invoicing
Business ID (Y-tunnus) / Invoicing reference (Purchase order (PO) number e.g.)
I’m aconscript, full-time student, unemployed or retired person(available only in IPMA Level D)

D.Education

A brief description of the education, training, and competence development activities related to project, program and portfolio management, and relevant tools, techniques, methods and solutions.

Brief descriptions of project management education

E.References(required for IPMA Level A, B, and C applications)

NOTE! One of references indicated below has to be the applicant’s foreman from the time claimed to satisfy the entry requirement (IPMA Level C), the reference project (IPMA Level B) or the reference program / portfolio (IPMA Level A) or the customer of the reference project / program.

The following individuals can be contacted for further information regarding my practical experience and background in the area of project management:

Surname / First name / Company / Telephone number
Signature(a personal signature is only required at IPMA Level A and IPMA Level B)
Surname / First name / Company / Telephone number
Signature (a personal signature is only required at IPMA Level A and IPMA Level B)

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F.Signature
With my signature I declare to be familiar with the certification process and relevant requirements.
With my signature I declare the information given on this form to be correct.
With my signature I accept the Project Management Association Finland need to collect in registry the relevant personal data regarding the certification applicants and certificate holders. This registry will be kept according to relevant laws, acts and decrees, and the information will not be released to third parties outside certification.
With my signature I accept the possibility of a non-certification-related (force majeur, information technology, etc.) fault in the certification process, and commit myself to not demanding compensation of any kind related to any such fault. PRYSERT commits to offer a compensatory event etc. for substituting the fault-ridden one without additional payment to PRYSERT. / Photograph
(Remove these instructions.
Add a photograph by copying / pasting here or by using the Insert – Picture menu command)
With my signature I declare myself to be familiar with the IPMA certified individual’s ethical instructions ( and my commitment to obey these instructions.
With my signature I accept the certificate prices listed on website at the time of signature.

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Location / Date / Applicant’s signature

Appendices to the application form

Level / A / B / C / D / certification renewal
Applicant’sCV / x / x / x / x / x
Self-assessment form / x / x / x / x / x
Project experience form / x / x / x / x
Project report / x
Reference project proposal / x
Reference portfolio / program proposal / x
Copy of valid student card or unemployment certificate etc. certification for discount pricing / (x)

The application must be submitted to the appropriate certification coordinator based on certification level through e-mail. A signed copy of the application form must be presented to the assessor(s) during the certification process. For further information please contact the appropriate certification coordinator:

IPMA Level A and B: / IPMA Level C and D:
ab-sertifiointi(at)pry.fi / cd-sertifiointi(at)pry.fi
Anne Isotalo / Kirsti Leppämaa

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