PMI Application Template

7/21/2019 PMI Application Template

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PMI Application Template (with Explanations)

Field Explanation

PMI Member ID#

Enter your PMI membership ID. It makes sense to

become a member before you apply for PMP, because:

Membership fee + PMP application fee for members

($534) < PMP application fee for non-members ($555)

For PgMP credential holders: Option-A orOption-B

Applies only in the unlikely event that you already have

a PgMP credential and are going for PMP. You may pick

either Option-A or Option-B. Option-A gives you 3 more

years to complete 60 PDU's but forfeits PDU's already

earned. Option-B carries the PDU's already earned but

potentially shortens the renewal cycle. Option-A isnormally preferred

Name for correspondence from PMI Name to be used for correspondence

Name on government issued ID

Name on the ID that you will carry and show at the

exam center

Name for your PMP certificate Name to be printed on the PMP certificate

Address, email, phone and fax

Enter home address and business address and choose

preferred address for correspondence. Fax is not

mandatory

Applicant's primary industry

Choose from the options provided or type in another

value after choosing "Other"

Highest level of education attained Pick among the choices provided

Did you graduate from a GAC accredited

university

GAC is a PMI program that provides accreditations to

project/program management courses. Directory of

GAC approved programs can be found here:

http://gacpm.org/Directory-of-GAC-Programs.html.

Pick "No, I attended another university" if your

program/university does not feature in this list

Field of study

Choose from the options provided or type in another

value after choosing "Other"




Project experience verification

One form per project (repeat rows 16 through 24 for

every project undertaken). General guidelines are:

1. The duration (measured as the difference between

completion date and start date) when combined across

all the projects entered should total at least 3 years

2. The sum of total hours worked on projects should

add up to at least 4500 (7500 if you do not have a

Bachelor’s degree)

3. Enter just enough experience. For example: even if

you have 15 years project experience, there is no need

to enter all of it here.

1. Project # Serial number. Start with most recent first

2. Project title

3. Project role Pick among the choices provided

4. Project industry

5. Job title

6. Organization name

7. Organization address

8. Primary contact

Please note:

1. Primary contact can either be project sponsor, your

manager/director, client or primary stakeholder

2. It is OK if you or the primary contact are no longer

with the organization3. Please make sure that the primary contact will be

able to (and be willing to) vouch for the details that you

entered on this form in the event of an audit

9. Number of hours and description of work

done on Initiating, Planning, Executing,

Controlling and Closing

Please note:

1. Use the definitions in Section of the PMBOK guide V5

to understand what processes/activities belong to each

of these process groups

2. You need not have worked on all processes on all

projects. Enter based on whatever processes you

actually worked on3. Be brief and concise in describing the work. For

example, instead of going "This project was for a large

fortune 500 customers with revenues of ....." write

"preparing the business case for the project". Focus on

what YOU did on the project




Education

Please note:

1. Total of 35 hours of education needs to be recorded

in this section.

2. Simplilearn being a REP, the PMP courses are pre-

approved for eligibility requirements

1. Course title

2. Institute Name Simplilearn

3. Category (A-F)

A: PMI register education providers. See this link to

ensure that the institute you took the course from is an

REP: http://www.pmi.org/Professional-

Development/REP-What-is-a-Registered-Education-

Provider.aspx. Please note Simplilearn is an REP

B. PMI chapters of CoP's

C. Employer/Company sponsoredD. Training companies or consultants

E. Distance learning companies

F. University/college

4. Start date

5. End date

6. Hours

7. Qualifying hours

Inclusion in communications from PMI Select based on preferences

Optional information Enter as desired

Special accommodations If required

Language aid for examination If required

Payment Payment related information

PMI Application Template

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