Job Title:
Years in Manufacturing:
Date of Birth:
BUSINESS ADDRESS
HOME ADDRESS
None
Company:
Address:
Division/Dept:
City:
Address:
State/Province:
PO Box/Mail Stop:
Zip Code:
City:
Country:
State/Province:
Phone:
Zip Code:
Email:
Check if
cell phone
Country:
Phone:
Cell Phone:
Technician
Bachelor
Doctorate
Associate
Master
None
Other Education:
Fax:
Email:
Please do not use my email address for communications outside of SME.
Online Exam:
Paper/Pencil Exam:
SME MEMBER
$490.00
$520.00
Online Exam:
Paper/Pencil Exam:
$245.00
$275.00
NONMEMBER
Online Exam:
Paper/Pencil Exam:
$490.00
$520.00
Online Exam:
Paper/Pencil Exam:
$245.00
$275.00
| Page 2 of 3
OPTIONAL: RECOMMENDED READING
Fundamentals of Manufacturing, 3rd Edition (BK11PUB15)
Fundamentals of Manufacturing Workbook (BK14PUB2)
Fundamentals of Manufacturing Package (PK14PUB2)
Nonmembers
SME Members
Nonmembers
SME Members
Nonmembers
SME Members
$120.00
$108.00
$30.00
$27.00
$135.00
$121.50
TOTAL:
SHIPPING METHOD (SELECT WHEN ORDERING RECOMMENDED READING)
FedEx Ground
FedEx Priority Next Day AM
ALL PRICES SUBJECT TO CHANGE. Shipping, handling, and applicable state taxes will be added to your total. Shipping charges are
based on your location and the method of shipping selected above. For a quote on shipping charges, call SME Customer Care at
800.733.4763 or 313.425.3000.
METHOD OF PAYMENT
Please remit application and payment to:
SME
Attn: Certification
One SME Drive
Dearborn, MI 48128
Check/Money Order (Payable to SME)
American Express
MasterCard
Visa
Discover
SME | v08_2014
| Page 3 of 3
Digital
Both
CERTIFICATION AUTHORIZATION
I hereby attest that all facts on this application are correct and no false
information has been supplied. Further, I release SME to make any
inquiries, which are necessary in ascertaining my qualifications for
certification. I agree to abide by the decision of the Certification
Oversight and Appeals Committee.
SME may release my exam score to my employer, instructor,
and/or school.
Signature:
Signature:
Date:
Date:
NOTE: This application, along with the Proctor Form and Agreement, must be received by SME at least two
weeks prior to your planned exam date.
SME | v08_2014