Application
This form may be completed by typing directly into the body of this PDF. Submit all portfolio materials electronically to
certification@turnaround.org. Mailing documents will delay processing. Please submit your completed application, a copy of
your diploma/transcripts, and Qualifications Statement to:
Turnaround Management Association e: certification@turnaround.org p: +1 312 578 6900 ext. 3 f: +1 312 578 8336
PERSONAL INFORMATION
First Name Middle Name Last Name Suffix
Date of Birth Business
Title
Business Address City State Zip
Business Telephone Business Fax
Home Address City State Zip
Email Preferred Method of Contact
Contact information (if not provided above)
REQUIREMENTS
I hereby apply for certification as a Certified Turnaround Professional and understand that my certification depends on my
ability to meet all the requirements and qualifications and is subject to the approval of the Standards Subcommittee. I certify that
the information contained in this application is true and correct. I further understand that if any information is later determined
to be false, TMA reserves the right to revoke any certification that has been granted on the basis thereof.
Indicate your understanding of and agreement to comply with the following by checking the boxes that precede each
statement:
o In making and filing this application for certification, I authorize all persons, firms and entities to furnish any relevant
information that may be requested by the Turnaround Management Association in connection with the investigation of
this application.
o I release and indemnify the Turnaround Management Association and its Board of Directors, ocers and employees from
any and all liability arising from the investigation and evaluation of this application, decisions relative to the granting of
certification, continuing professional education requirements and standards of practice.
o I have never had a professional license or certification suspended or revoked.
o I acknowledge that all other sections, paragraphs and parts of this application are incorporated herein without specific
reference.
o I have read and agree to comply with the Code of Ethics.
o I have read and agree to abide by the Rule and Regulations of the CTP and CTA Certification Programs.
o I am not under any SEC or criminal investigation by any government or regulatory authority, nor any other investigation
or proceeding pending with any professional or certification entity. I understand if I am, I must fully disclose this and all
details on a separate document.
o
I have not been convicted of a felony.
By providing my handwritten or electronic signature dated below, I indicate my understanding of and agreement to comply
with the terms of this application.
Applicant Signature Date
CTP APPLICATION | PAGE 1
click to sign
signature
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PAYMENT
Signed form must be mailed, faxed, or emailed with payment of $295 USD.
Mail checks to Turnaround Management Association, P.O. Box 95172, Chicago, IL 60694-5172.
o (payable in U.S. funds to Turnaround Management Association)Check number: ____________
Credit Card
o
Visa o MasterCard o American Express
Credit Card Number Expiration DateName on Card Security Code
TURNAROUND WORK HISTORY
Please indicate the experience level you meet:
o 4—11 Years Turnaround Experience
o Twelve (12) or More Years of Turnaround Experience
Qualifying experience would be defined as the following roles: CRO or equivalent, Assignee for the Benefit of Creditors,
Turnaround Team Leader, Plan Administrator or Liquidating Trustee, Receiver, Interim Manager Working on Turnaround.
CURRENT EMPLOYER
End Date CompanyStart Date Title
StateCity
Job Description
PREVIOUS EMPLOYER
End Date CompanyStart Date Title
StateCity
Job Description
PREVIOUS EMPLOYER
End Date CompanyStart Date Title
StateCity
Job Description
PREVIOUS EMPLOYER
End Date CompanyStart Date Title
StateCity
Job Description
CTP APPLICATION | PAGE 2
PREVIOUS EMPLOYER
End Date CompanyStart Date Title
StateCity
Job Description
PREVIOUS EMPLOYER
End Date CompanyStart Date Title
StateCity
Job Description
ADDITIONAL QUALIFICATIONS
Individuals who hold the CIRA designation offered through AIRA are exempt from the accounting and finance examination
and those who have earned their Juris Doctorate may waive the law examination. If you intend to waive either section, please
check the box below and provide proof with your application.
oCIRA o Juris Doctorate
CTP APPLICATION | PAGE 3