Regional and Studio Exam Financial Sheet and Payment

Regional and Studio Examination Financial Sheet and Payment Form

Please use this form to submit financial report and payment for Regional Exam sessions and CCA studio exam sessions. This form should be filled by Regional Registrars or Studio Exam Hosts only.

"*" indicates required fields

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Exam Host/ Committee Registrar Information

Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Email*

Date of Exam Session*

Location

My CCA membership dues are up to date.

Student Exam Fees

Exam-Primary I, II, & III

Price: $150.00

Exam-Grade I

Price: $60.00

Exam-Grade II

Price: $65.00

Exam-Grade III

Price: $75.00

Exam-Grade IV

Price: $85.00

Exam-Elementary (V)

Price: $115.00

Exam-Intermediate (VI)

Price: $130.00

Exam-Advanced (VII)

Price: $150.00

Exam-Diploma

Price: $250.00

Additional Exam Fee for Student Exams Grade I-IV with 1-2 Candidates

Price: $25.00

Teacher Exam Fees

Exam-Teacher-Grade I

Price: $150.00

Exam-Teacher-Grade II

Price: $150.00

Exam-Teacher-Grade III

Price: $175.00

Exam-Teacher-Grade IV

Price: $200.00

Exam-Teacher-Elementary (V)

Price: $250.00

Exam-Teacher-Intermediate (VI)

Price: $350.00

Exam-Teacher-Advanced (VII)

Price: $450.00

Exam-Teacher-Diploma

Price: $550.00

Total Exam Fee:

Credit Card Billing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Payment Method

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name