2009
The Accredited ACH Professional Program
Online AAP Test Registration Form

Test Window: October 12 - 30, 2009

Complete the form below and designate your payment method. Check out test site locations before completing registration form. Please note that test site locations may be subject to change. http://www.lasergrade.com/nas.shtml Note any special needs or requirements in the “comments” section. Read and accept the AAP Program Policies. “Submit” your AAP Test Registration Form. Processing your registration form will begin when payment is received. An email confirmation of payment will be forwarded to you from our accounting department. Registration Policies: click here to view detailed AAP Program Policies All registrations must be accompanied by payment, otherwise they will not be processed. Invoices will not be sent, The registration cut-off date is September 15, 2009 Registrations received after September 1, 2009 are not eligible for partial refunds. Late registration will be accepted between September 16 and 25, 2009 only under the following circumstances: the completed registration form and payment (including payment for overnight shipping of registration materials) must be received by NACHA no later than opening of business on Monday, September 29, 2009; payment must be made by credit card; registrants must provide a Federal Express account number or must authorize NACHA to bill extra funds to his or her credit card for overnight delivery of registration materials. Late Registration: NACHA will accept late registrations received between September 16 and September 25, 2009, under the following circumstances: a late registration fee of $50 is remitted in addition to the standard registration fee; the completed registration form and payment (including payment for overnight shipping of registration materials) is received at NACHA no later than the opening of business on Monday, September 28, 2009; payment is made by credit card; and registrant has provided a Federal Express account number or given NACHA authorization to bill extra funds to his or her credit card for the overnight delivery of registration materials.

To receive a member rate please specify your NACHA Affiliation or Regional Payments Association.
 
 NACHA Member     
_{If yes, specify}   NOT SELECTED Affiliate Program Council for Electronic Billing & Payment Cross-Border Council Electronic Benefits Transfer Council Electronic Check Council The Financial EC Council The Internet Council

 Regional Payments Association Member
_{If yes, specify name}

CANDIDATE MAILING INFORMATION (Please note that the name used on this form should be the same as your photo id as it will be required for admission to the testing centers) Candidate Name MR MS MRS   Title Institution Street Address Suite City State Zip Phone Fax E-mail Immediate Supervisor Type of Candidate New AAP Candidate Reaccreditation Candidate Years of ACH Experience   NOT SELECTED Less than 2 2-5 6-8 9-10 More than 10 Position NOT SELECTED Accounting Branch Manager Business Development Cash Management Operations Product Development Product Management Sales\Marketing Other    If, other Education (Check highest degree earned)    NOT SELECTED High School College Graduate Type of Institution (Check ONE Only) NOT SELECTED CORPORATE-Service CORPORATE-Sales CORPORATE-Manufacturing CORPORATE-Consulting FINANCIAL INSTITUTION-Bank FINANCIAL INSTITUTION-Credit Union FINANCIAL INSTITUTION-Savings & Loan ASSOCIATION-National ASSOCIATION-Regional ASSOCIATION-State GOVERNMENT-Federal GOVERNMENT-State GOVERNMENT-Local OTHER If, other Size by Assets/Sales $ Industry (Check ONE Only) NOT SELECTED Banking-Retail Banking-Wholesale Computer Services/Sales Financial Services Health Services Insurance Manufacturing Petroleum/Chemical Retail Securities Telecommunications Other If other Preferred Testing Location

Before continuing with your registration we recommend you visit PSI website to check availability of test sites in your area.  Please note that test site locations may be subject to change. http://www.lasergrade.com/locate.shtml

Registration Fee

$60 of the candidate’s registration fee is non-refundable in the event that a candidate should request a cancellation of his exam registration (please refer to the AAP Program Policies for more details). $400 Member $515 Nonmember $50 Late Registration Fee (will be charged in addition to the standard registration for all who register between September 16th and 26th) Payment Method OPTION 1- Payment by ACH Credit     Date ACH Credit will be sent ACH Network Routing # 021052053.  UPIC/Account #59058945. Use the CCD format for single registrations.  Include in the Batch Header Record:  (1) Name of company in "Company Name" field.  (2) Last name and first  initial of  registrant in "Company Discretionary Data" field. (3) "AAP09" in the "Company Entry Description" field.  For multiple registrations, use CCD+ format with a type  '05' Addenda Record.  Complete "Company Name" and "Company Entry Description" and identify registrants by last name and first initial in the Note Segment of Addenda Record. OPTION 2 -Payment by Credit Card.  I authorize NACHA to charge the credit card below for the AAP Test registration amount selected for purchase via its Web site.        NOT SELECTED VISA MASTERCARD DINERS CLUB AMERICAN EXPRESS DISCOVER                            Account Number Expiration  Date Name on Card Billing Address: (if different than above) Street Address Suite City State Zip Comments: AAP Program Policies – please read before continuing I have reviewed and accept the AAP Program Policies.