Recertification applications will not be accepted if they are dated more than 4 months prior to the date of recertification.  June 30 applications will only be accepted after March 1 and December 31 applications will only be accepted after September 1

The number of contact hours of education needed for recertification will be increased and phased in according to this schedule:
June 30 and December 31, 2010 – 60 hours
June 30 and December 31, 2011 – 70 hours
June 30 and December 31, 2012 – 80 hours
Beyond December 31, 2012 – 80 hours

 
PERSONAL DATA:    
Last Name & suffix (if any):
First & Middle Names and/or Initials:
Name as desired on Certificate
Work Address:
Institution:
Title:
Department:
Work Address 1 (street):
Work Address 2 ( building, suite...):
Work City
Work State:
Work Zip:
Work Phone:
Work Fax:
Home Address:
Home Address 1 (street):
Home Address 2 (apt. suite...):  
Home City:
Home State:
Home Zip:
Home Phone:
Home Fax:
Should RACC Correspondence go to your Work or Home Address? Work   Home  
 
Email: (Enter valid permanent email address)
Payment Selection:

PayPal
Organization Check
Personal Check
Please do not forget to complete the rest of the form describing your experiences required for recertification!

  
PLEASE SEND RECERTIFICATION FEE OF $175.00 TO:
RACC, 1350 Broadway, 17th Floor, New York, NY 10018.  RACC's tax id # is 13-3674722
Click here to make a PayPal payment

 

 
Recertification Information:
Current Certification Number:
Expiration Date:

Month: (mm) 
Year: (yyyy) 


Background Information:

A: Percent of working time currently spent in research or sponsored programs:
Less than 25% 25 - 50%   51-75% More than 75%
  
B. Total experience in research or sponsored programs administration:
3 years 4-7 years 8 years 9-15 years
more than 15 years
  
C. Primary Employer:
University-Medical Univeristy-
Nonmedical		 Hospital-Medical Center Independent Research Org.
Industrial Federal Government State, Province or Local Gov. Corporation/
Professional Services
Other
  
D. Primary Job Responsibility:
Operational Managerial Policy Other
  
E. Highest Academic Level Attained:
High School Some College Associate's Degree Bachelor's Degree
Master's Degree Doctoral Degree Other  
  
F. To which of the following organizations do you belong?
AIRI AUTM COGR LES
NACUBO/CAUBO NCMA NCURA/CAURA NGMA
SRA

 

Research Administration and Educational Activities:

A.     RESEARCH ADMINISTRATION ACTIVITIES IN THE LAST FIVE YEARS

 Directions:  To recertify, candidates must show current and past job responsibilities indicating continuous activity in the field of research administration for at least three (3) of the last five (5) years.  Please complete the information requested below, providing a brief description of activities meeting this requirement. All applications are subject to audit and will be randomly selected for verification of the information provided.  Candidates whose applications are selected for audit will be notified on receipt of the application and they will be requested to document all entries.

Employer:
From: To:
Address:
City:
State: Zip:
Job Title:
Research Administration Activity:

Employer:
From: To:
Address:
City:
State: Zip:
Job Title:
Research Administration Activity:

Employer:
From: To:
Address:
City:
State: Zip:
Job Title:
Research Administration Activity:

 

B.     EDUCATIONAL ACTIVITIES

Please list below educational activities from the last five years which meet the recertification requirements of forty (40) contact hours of continuing education (60 hours in 2010; 70 hours in 2011; and 80 hours in 2012 and beyond), OR activities without contact hours which are equivalent. These may include teaching, serving on professional journal or newsletter review boards, writing articles, serving on a board of a relevant national association, participating in workshops and seminars, as well as academic courses at an undergraduate or graduate level. Academic credits will be considered as contact hours. Note that all CRAs are responsible for maintaining their education records OR records of activities without contact hours which are equivalent. The RACC will randomly audit 10% of the recertification applications. If your application is selected for audit you will be required to produce documentation of your contact hours. 

ALL contact hours must be earned in activities that are directly related to topics found in the CRA test content outline.
Month/Year
Institution (Name & State)/Provider/Sponsor (Location)
Course Title/Activity/Topic:
Hours:
Month/Year
Institution (Name & State)/Provider/Sponsor (Location)
Course Title/Activity/Topic:
Hours:
Month/Year
Institution (Name & State)/Provider/Sponsor (Location)
Course Title/Activity/Topic:
Hours:
Month/Year
Institution (Name & State)/Provider/Sponsor (Location)
Course Title/Activity/Topic:
Hours:
Additional Space if Required:
C. CANDIDATE AFFIRMATION/AUTHORIZATION

Please provide 3 questions for use on a future Certified Research Administrator examination.  It MUST be multiple choice with 4 responses (do NOT use None of the Above, All of the Above, A and B above, etc). and please identify which response is the correct answer.
 

D. CANDIDATE AFFIRMATION/AUTHORIZATION

I affirm that all statements given on this Application are true and correct to the best of my knowledge and that the RACC is hereby authorized to contact any organization or individual listed hereon to verify my continuing education history.

The cost of recertification is $175.00 RACC's tax id # is 13-3674722