Application For C RISC Certification: For Individuals Who Passed A CRISC Exam Administered in 2015 and Later
Application For C RISC Certification: For Individuals Who Passed A CRISC Exam Administered in 2015 and Later
Application For C RISC Certification: For Individuals Who Passed A CRISC Exam Administered in 2015 and Later
HANDWRITTEN INSTRUCTIONS
1. Print and complete the application.
2. Sign and date page A-1 and V-1 using a handwritten signature.
3. Have your verifier(s) sign and date page V-1 using a handwritten signature.
4. Scan the form back into a computer.
1
Application for CRISC Certification
Exam Passers 2015 and Later
Application Instructions
Work Experience Form (Pages A-1 & A-2)
APPLICATION PAGE A-1
Section A—Information Security Management Experience
For each employer (starting with the most current), enter the following information:
1. Company Name. Enter the name of the company where CRISC tasks were performed. Use one
assessment box for each employer.
2. CRISC Domain Work Experience. For each domain in which you earned experience, enter the period of
time (in the From MM/YY and To MM/YY boxes) that you performed tasks within the domain (see page V-
2 for domains and task statements), and the years/months of experience that you are claiming with this
employer. Do not leave dates blank. If currently employed, include a date or current, now, present, etc. To
qualify you need 3 years of cumulative experience across a minimum of 2 domains, one of which must be
in either domain 1 or 2.
3. Total. Do not add column figures; your total experience is the actual ‘length of time’ working in all the
domains. Total years/months of experience cannot exceed the total length of employment with this
company.
Repeat these steps for each employer for which you are claiming CRISC experience.
If you are using more than 3 employers, please print out additional copies of page A-1.
Example: If in 2011 and 2012, you worked the entire year in domains 1 and 2 with this company and in 2013 you
only worked in domain 4 for the entire year for an employer, you would enter:
In the example above your total length of time in all the domains is 3 years (2011-2013) NOT column total of 5
years.
2
Application for CRISC Certification
Exam Passers 2015 and Later
Application Instructions
Verification of Work Experience Form (Pages V-1 & V-2)
The applicant is required to have their work experience claimed verified by a person qualified to do so.
If you need more than one verifier, you may complete or print additional copies of pages V-1 & V-2.
3
Application for CRISC Certification
Exam Passers 2015 and Later
Application Instructions
Instructions for Submitting Your Application for CRISC Certification
For your application to be efficiently processed, please collect all verification of work experience form(s)
and submit your completed Application for CRISC Certification online at: https://support.isaca.org
Topic: Certifications & Certificate Programs Category: Application Process
Please allow approximately two weeks for the processing of your completed Application for CRISC Certification.
Verification forms may be subject to an audit and verifiers may be contacted to confirm their completion and
verification of the work experience form that they signed.
Upon approval, you will be notified by an email sent to the email address indicated in your ISACA profile. You will
also be sent a certificate package via mail to the address listed in your ISACA profile containing a letter of
certification, a CRISC pin and your CRISC certificate.
Application Link and Last Date to Apply Application has not been received or logged into the record.
for Certification
Complete Under Review Application is going through the review process. An email message will
be sent if any additional information/documents are needed to complete
your application.
Complete Pending Audit Application was selected for a random verifier audit and ISACA is
awaiting response from the verifier.
Approved Application has been tentatively approved and will be certified in the
next grouping or certifying batch for that certification unless selected
for the random verification audit.
4
Application for CRISC Certification
Exam Passers 2015 and Later
Page A-1
Applicant Information
Applicant Name_ __________________________________________________________________________ ISACA ID#_ ________________________
TOTAL CRISC overall domain related experience: Must be 3 or more years of cumulative experience across 2 CRISC domains, one
of which must be in either domain 1 or 2.
A-1
Application for CRISC Certification
Exam Passers 2015 and Later
Page A-2
Applicant Information
Applicant Name_ __________________________________________________________________________ ISACA ID#_ ________________________
Verifier Name______________________________________________________________________________________________________________
Verifier Name______________________________________________________________________________________________________________
I hereby apply to Information Systems Audit and Control Association, Inc. (ISACA) for the By signing below, I authorize ISACA to disclose my Certification status. This contact information
Certified in Risk and Information Systems Control (CRISC) certification in accordance with and will be used to fulfill my Certification inquiries and requests. By signing below, I authorize ISACA
subject to the procedures and policies of ISACA. I have read and agree to the conditions set to contact me at the address and numbers provided and that the information I provided is my
forth in the Application for Certification and the Continuing Professional Education (CPE) Policy own and is accurate. I authorize ISACA to release confidential Certification application and
in effect at the time of my application, covering the Certification process and CPE policy. certification information if required by law or as described in ISACA’s Privacy Policy. To learn
I agree: to provide proof of meeting the eligibility requirements; to permit ISACA to ask for more about how we use the information you have provided on this form, please read our Privacy
clarification or further verification of all information submitted pursuant to the Application, Policy, available at www.isaca.org/privacy.
including but not limited to directly contacting any verifying professional to confirm the
information submitted; to comply with the requirements to attain and maintain the certification, I hereby agree to hold ISACA, its officers, directors, examiners, employees, agents and those
including eligibility requirements carrying out the tasks of a CRISC, compliance with ISACA’s of its supporting organizations harmless from any complaint, claim, or damage arising out
Code of Ethics, the fulfillment of renewal requirements; to notify the ISACA certification of any action or omission by any of them in connection with this Application; the application
department promptly if I am unable to comply with the certification requirements; to carry out process; the failure to issue me any certificate; or any demand for forfeiture or redelivery of
the tasks of a CRISC; to make claims regarding certification only with respect to the scope for such certificate. Not withstanding the above, I understand and agree that any action arising out
which certification has been granted; and not use the CRISC certificate or logos or marks in a of, or pertaining to this application must be brought in the Circuit Court of Cook County, Illinois,
misleading manner or contrary to ISACA guidelines. I understand and agree that my Certification USA, and shall be governed by the laws of the State of Illinois, USA.
application will be denied and any credential granted me by ISACA will be revoked and forfeited
in the event that any of the statements or answers provided by me in this Application are I UNDERSTAND THAT THE DECISION AS TO WHETHER I QUALIFY FOR
false or in the event that I violate any of the examination rules or certification requirements. I CERTIFICATION RESTS SOLELY AND EXCLUSIVELY WITH ISACA AND THAT THE DECISION
understand that all certificates are owned by ISACA and if my certificate is granted and then OF ISACA IS FINAL.
revoked, I will destroy the certificate, discontinue its use and retract all claims of my entitlement
to the Certification. I authorize ISACA to make any and all inquiries and investigations it deems I HAVE READ AND UNDERSTAND THESE STATEMENTS AND I INTEND TO BE LEGALLY
necessary to verify my credentials and my professional standing. I acknowledge that if I am BOUND BY THEM.
granted the Certification, my certification status will become public, and may be disclosed by
ISACA to third parties who inquire. If my application is not approved, I understand that I am Name
able to appeal the decision by contacting [email protected]. Appeals undertaken by a
Certification exam taker, Certification applicant or by a certified individual are undertaken at
the discretion and cost of the examinee or applicant. Signature & Date
(For your application to be complete you must include your name, signature and date above.)
A-2
Application for CRISC Certification
Exam Passers 2015 and Later
Page V-1
Verification of Work Experience Form (page 1 of 2)
Applicant Name_ __________________________________________________________________________ ISACA ID#_ ________________________
certification. As such, my work experience in identifying, assessing, mitigating and responding to risk, and monitoring and reporting on risk and control
must be independently verified by individuals knowledgeable of my work experience (current or previous employer). The individual verifying the work
experience must be an independent verifier and not of any relation to the applicant nor can the applicant verify his/her own work. If I currently or once
worked as an independent consultant, I can use a knowledgeable client or colleague to perform this role.
Please verify my IT risk and/or IS control-related experience as noted on my attached application form, and as described by the CRISC job practice
domains and task statements (see page V-2). Please return the completed form to me for my submission to ISACA. If you have any questions
concerning this form, please direct them to support.isaca.org or call +1.847.660.5660. Thank you.
____________________________________________________________________________________
Applicant Signature Date
Address_____________________________________________________________________________________________________________________
Street
___________________________________________________________________________________________________________________________
City State/Province/Country Postal Code
I am attesting to the employment experience listed in Section 1—Employment History. Enter box number (Box 1, Box 2, etc) or employer
(company) name. List all that apply to this verification.
________________________________________________________________________________________________________________________
1. I have functioned in a supervisory or other related position to the applicant and can verify his/her work experience. Yes No
(Section 1 of the application)
If no, identify why you are able to verfy. ________________________________________________________________________________________
2. I can attest to the duration of the applicant’s work experience on this application with my organization. Yes No N/A
If no, I attest to experience from _________ to _________.
3. I can attest to the duration of the applicant’s work experience on this application prior to his/her affiliatio Yes No N/A
with my organization.
4. I can attest that the tasks performed by the applicant, as checked on the verification form page V-2, Yes No
are correct to the best of my knowledge.
5. I can attest to the fact that the applicant is competent in performing the tasks as checked on the verificatio Yes No
form page V-2.
6. Is there any reason you believe this applicant SHOULD NOT be Certified in Risk and Information Systems Yes No
Control by ISACA?
________________________________________________________________________________________________________________
Verifier Signature Date
V-1
Application for CRISC Certification
Exam Passers 2015 and Later
Page V-2
Verification of Work Experience Form (page 2 of 2)
Verifier Name________________________________________________________________________________________________________________
V-2