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PCH Associate School Enrollment Form
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PCH Associate Program School/Proctor Enrollment Form

This form should be completed when you know the number of students who will be taking the exam and the exam date.  You can submit multiple forms in one year.

Please submit this form at least TWO WEEKS PRIOR to the exam date in order for PLNA to have time to prepare the exams.

Your enrollment form will be reviewed within 48 hours of submission and you will receive an email confirmation upon approval.

Please ensure there is at least 2 (two) weeks between the date of this submission and the exam date.
Please list the names (First and Last) of the students taking the exam and their expected graduation dates (MM/DD/YYYY)
A $25 fee will be charged for each student who passes the exam and wants to be added to the PCH Associate List. Schools can pay in advance. Any exams not passed will result in a credit to the school toward future exams. Please select one option below based on the school's policy:

If Payment Option 1 is selected, an invoice will be sent to the school upon approval of this form. If there are exams given and not passed this will result in a credit to the school toward future exams.


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