FALDP Certification Form

Certification Renewal

FALDP Certification

Please note that all fields followed by an asterisk must be filled in.

First Name*

Last Name*

E-Mail Address*

Web Site URL

Business Phone*

Business Name*

Have you completed at least 10 CEUs within the past year?*

Yes

Please list CEU's with values. If you're relying on CEU's from sources other than FALDP, describe activity and hours spent.*

FALDP Certification is an internal certification only. I will display the FALDP Certified logo only while I am a member in good standing; and I am subject to liquidated damages of up to $5000 if I continue to display the FALDP Certified logo, or claim to be FALDP Certified if I am no longer a member in good standing.*

I acknowledge and agree.

GDPR*

	I am at least 16 years of age.
	I have read and accept the privacy policy.
	I understand that you will use my information to contact me or send me the information I requested.

Please enter the word that you see below.

800-515-0496

FALDP Certification and renewal

FALDP Certification

FALDP Certification