Certification Exam Retake Application

Certification Exam Retake Application

Written - Fabrication
When: The Certification Exam is available April 1 - December 31

Where: The written exam is administered at a Meazure Learning testing site (US & Canada Only). The Fabrication Exam is completed at candidates office.

Upon application approval, candidates will be contacted directly by the administrator to schedule the exam.

NOTE: Please read the "Exam Candidate Handbook" for more on the fabrication timeline and requirements.

A processing fee of $300.00 will be charged for all rejected applications.

Written Exam = $600 USD

Fabrication Exam = $700 USD (+$300 USD for exams in Canada)

Written + Fabrication = $1500 USD (+$300 USD for exams in Canada)

The Exam is only available in English.

*Translators and/or dictionaries are not allowed*
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Personal E-mail (NEBO Comm. Only)*
example@example.com
Personal Phone Number (NEBO Comm. Only)*

Area CodePhone Number
Business Email
example@example.com
Business Phone Number*

Area CodePhone Number
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Color Copy/photo of Government issued ID*

Browse Files

Cancelof
APPLICATION STATEMENT, SIGNATURE AND DATE
Because of functional limitations imposed by disability, special arrangements will be necessary for me to complete the certification examination (If yes, please send a current letter from your licensed professional stating your needs as well as other information on separate page and attach to application.)*

YesNo
Application to this examination shall be considered without discrimination as to age, sex, race, religion, sexual orientation, national origin, handicap, or marital status.

I certify that the information supplied in this application is true and accurate to the best of my knowledge.

I also acknowledge that the National Examining Board of Ocularists may refuse to accept this application, decline permission to take this examination, invalidate my scores or decline to present a certificate to me if evidence is received regarding false statements that I have made in this application, or in any other form submitted to the National Examining Board of Ocularists.

I also acknowledge that I have downloaded and read, in its entirety, the booklet entitled “Exam Candidate Handbook”, of the National Examining Board of Ocularists.

I understand that the National Examining Board of Ocularists will verify information in this application.

I grant NEBO permission to contact any sources listed in the application and authorize the release of any personal information NEBO requests. Inaccuracies in the application may result in rejection of this application and forfeiture of application fee and/or withholding of certification.
Signature*

Clear
Please select below how payment will be made:

Check may be mailed to NEBO, 2050 Keokuk St., NEBO Suite, Iowa City, IA 52240

Or

Email invoice sent from Square to the email listed on this form.
Payment Type*
Should be Empty:

Certification Exam Retake Application

APPLICATION STATEMENT, SIGNATURE AND DATE