ASTACAP Exam Site Registration Form

ASTACAP Exam Site Registration Form

This form is to notify the National Office of ASTACAP In-Person Exams in your state and to enroll in the event.

* ASTACAP is an official ASTA program.

* All ASTACAP exams must be registered with ASTA state and national offices.

* Licensing fees must be submitted to the ASTA National Office PRIOR to the office mailing your certificates.

Please allow 4-6 weeks for us to process your request. Once we have mailed your certificates.

ASTACAP Exam Site Information

Please provide the details of the location.

ASTA State Chapter Sponsoring the ASTACAP Exam*

Registration Website Link*

For ASTA to link on the National website.

ASTACAP Exam Site Location Name*

ASTACAP Site Exam Address*

ASTACAP Exam Site Address 2

ASTACAP Exam Site City, State, Zip Code*

ASTACAP Exam Site Date(s)*

Number of Student Participants*

ASTA Requires Proof of Liability Insurance for In-Person Events as ASTACAP is a registered trademark of ASTA.

Will you be using ASTA Liability Insurance through Huntington T Block?*

Yes

Please collect your State Chapter ASTA HTB Liability Insurance documents and upload the confirmation email that our insurance company contact will cover your event.

Name of Liability Insurance Company*

Policy Group*

Policy Number*

ASTACAP Site Coordinator, State Chapter President, and ASTACAP Chair Information

Materials will be mailed to the site coordinator at this address. The site coordinator, state president, and ASTACAP chair must be a current ASTA members.

MAIL TO: Site Coordinator Name*

MAIL TO: Site Coordinator Address*

MAIL TO: Site Coordinator City, State, Zip Code*

State Chapter President Name*

State Chapter President Email*

An email will be sent to the president from Smartsheet Automations to approve the event. Please ensure that they are ready to receive this email.

State Chapter ASTACAP Chair Name*

State Chapter ASTACAP Chair Email*

Examiner and Student Registration

All Examiners and Teachers must be ASTA Members.

Please provide a list of all examiners (full name and email).

Please provide a list of all teachers (full name and email).

Please use this link as a guide.

(To Download: Click "File," then "Create a Copy," then "Download a Copy")

Upload Documents here:*

Please include:

1) Examiner lists and Student Registrations (Must be in Excel or Google Sheets)

2) Proof of Liability Insurance

Drag and drop files here or

How would you like to pay the $10 licensing fee per test?*

Check

Credit Card

Please look for an email from Anna Correa (acorrea@astastrings.org) with a link to pay online. It can take up to 1 week to process.

Please mail your checks to:

ASTA

P.O. Box 551

Annapolis Junction, MD, 20701

Please include your state chapter in the memo line.

Send me a copy of my responses

Privacy Notice|Report Abuse