PFT Exam Eligibility ID Request – North America "*" indicates required fields Legal Name*You are required to present a valid, government-issued photo identification as part of the check-in process. Your identification must contain your full name and a recent, recognizable photo. NOTE: if you have a suffix after your last name ( Jr., Sr., II, III, etc.) please include with your last name. First Middle Last Email* Address*Your residential address. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Do you have a valid CPR card?*You must have a valid CPR card or certificate before you can take the exam. Refer to Exam Requirements policy. The name listed on your CPR card must match your Driver’s License. If it does not, please stop and do no complete this form. Please contact testing@nestacertified.com for additional instructions. Yes No A valid CPR card is required at the time of testing. You must be CPR certified before you may take the PFT exam. Please exit this form and return when you have a valid CPR card. Refer to Exam Requirements policy. Are you 18 years or older and have a high school diploma or equivalent?*As per our exam policies, exam candidates must be 18 years of age or older and have a high school diploma or equivalent. Yes No Please do not complete this form until you have reached 18 years of age. Refer to Exam Requirements policy. Please exit this form and return when you have reached 18 years of age. What is the highest level of education completed?*High School (or equivalent) graduateAssociate’s degreeBachelor’s degreeMaster’s degreeDoctoral or Professional degreeAs per our exam policies, exam candidates must be able to provide proof, if the exam candidate is chosen during an audit.Graduation Date:* School/college/university name:* City:* State/Province:* Country:* Do you agree and understand the following PFT exam candidate responsibilities and exam policies?*All PFT exam candidates are required to read the PFT Exam Candidate Handbook prior to scheduling their exam. When you agree to our policies, you are acknowledging and understand your exam scheduling responsibilities and exam policies. Note: Exam candidate may be subject to an audit to verify proof of documentation requirements (show proof of valid CPR card/certification, Driver’s License or Passport, High School Diploma or equivalent) Yes, I agree to maintain the confidentiality of the exam content and abide by exam policies as stated in the candidate handbook Yes, I agree to adhere to the NESTA Code of Ethics Yes, I understand I may be subject to an audit to verify proof of documentation requirements No, I do not agree How do you intend to use your certification?*EmploymentSelf-EmploymentPersonal DevelopmentPlease download and read the PFT Exam Candidate Handbook located at: PFT Exam Candidate Handbook Please exit this form and return when you have read the PFT Exam Candidate Handbook.
