CVA Designation Application Please complete the information below: Your name and address exactly as you wish it to appear in NACVA’s Online Directory and on your CVA Certificate. To better serve you, NACVA requests a curriculum vitae and a business photo (head shot) be submitted along with your application. Please read the certification criteria provided in The Association brochure prior to submitting this application. Question Title * SECTION A: First Name: Last Name: Firm Name: Supervisor/Employer (if applicable): Address: City: Province/State: Country: Postal Code: Fax: E-mail: Tel: Question Title * Enter Professional Designation(s) Held ABV - Accredited in Business Valuation ASA - Accredited Senior Appraiser CA - Chartered Accountant CEPA - Certified Exit Planning Advisor CFA - Chartered Financial Advisor CFD - Certified in Fraud Deterrence Analyst CFE - Certified Fraud Examiner CFF - Certified in Financial Forensics CFP - Certified Financial Planner CIRA - Certified Insolvency and Reorganization Accountant CM&AA - Certified Merger & Acquisition Advisor CMA - Certified Management Accountant CPA - Certified Public Accountant Cr.FA - Certified Forensic Accountant DABFA - Diplomat of the American Board of Forensic Accounting ESQ - Esquire JD - Juris Doctor - Master of Law MAI - Member (Accredited) with Appraisal Institute MBA - Master in Business Administration PhD - Doctor of Philosophy (Higher Education Degree) Question Title * *May we take the liberty to contact your supervisor/employer to extend our appreciation for their support in your pursuit of the CVA? Yes No N/A Question Title * Signature (Enter your full name and date to provide your electronic signature attestation). Full Name: Date: Your signature will authorize NACVA to confirm the information in this application via e-mail and/or fax, if necessary, and authorize NACVA to use either medium for future communication. NACVA will not disclose or share this information with third parties to secure confidentiality as described in the confidentiality policy in the CVA/MAFF Candidate Handbook.By signing this application, you acknowledge: That you have read and understand the information in the CVA/MAFF Candidate Handbook (for CVA applicants). That you agree to: adhere to the Code of Conduct, keep all exam content confidential and not disclose or share in any manner content of the exam, and abide by all certification program policies. That you agree to promptly inform NACVA of any matters that affect your capability to fulfill CVA certification requirements. That you agree to comply with all certification requirements and provide NACVA with information, as needed, to confirm that you meet all requirements. That in the event your certification expires or is suspended or revoked, that you will refrain from any use of the certification or certification status in any manner and that if your certification is suspended or revoked, you will return any CVA certificates to the VCB. That you agree to make claims regarding certification consistent only with the scope of the CVA, to not make any statement regarding certification that is misleading or unauthorized by NACVA, and not to use the certification in any manner that would bring NACVA or the VCB to dispute. That you agree to allow NACVA to perform such audit procedures it deems necessary to validate the information provided herein, including your experience in business valuation and related areas. Next