PMI Application Template (with Explanations)
Field
PMI Member ID#
For PgMP credential holders: Option-A or
Option-B
Name for correspondence from PMI
Name on government issued ID
Name for your PMP certificate
Address, email, phone and fax
Applicant's primary industry
Highest level of education attained
Did you graduate from a GAC accredited
university
Field of study
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Explanation
Enter your PMI membership ID. It makes sense to
become a member before you apply for PMP, because:
Membership fee + PMP application fee for members
($534) < PMP application fee for non-members ($555)
Applies only in the unlikely event that you already have
a PgMP credential and are going for PMP. You may pick
either Option-A or Option-B. Option-A gives you 3 more
years to complete 60 PDU's but forfeits PDU's already
earned. Option-B carries the PDU's already earned but
potentially shortens the renewal cycle. Option-A is
normally preferred
Name to be used for correspondence
Name on the ID that you will carry and show at the
exam center
Name to be printed on the PMP certificate
Enter home address and business address and choose
preferred address for correspondence. Fax is not
mandatory
Choose from the options provided or type in another
value after choosing "Other"
Pick among the choices provided
GAC is a PMI program that provides accreditations to
project/program management courses. Directory of
GAC approved programs can be found here:
http://gacpm.org/Directory-of-GAC-Programs.html.
Pick "No, I attended another university" if your
program/university does not feature in this list
Choose from the options provided or type in another
value after choosing "Other"
 One form per project (repeat rows 16 through 24 for
every project undertaken). General guidelines are:
1. The duration (measured as the difference between
completion date and start date) when combined across
all the projects entered should total at least 3 years
2. The sum of total hours worked on projects should
add up to at least 4500 (7500 if you do not have a
Bachelor’s degree)
3. Enter just enough experience. For example: even if
you have 15 years project experience, there is no need
Project experience verification to enter all of it here.
1. Project # Serial number. Start with most recent first
2. Project title
3. Project role Pick among the choices provided
4. Project industry
5. Job title
6. Organization name
7. Organization address

Please note:
1. Primary contact can either be project sponsor, your
manager/director, client or primary stakeholder
2. It is OK if you or the primary contact are no longer
with the organization
3. Please make sure that the primary contact will be
able to (and be willing to) vouch for the details that you
8. Primary contact entered on this form in the event of an audit

9. Number of hours and description of work
done on Initiating, Planning, Executing,
Controlling and Closing
Please note:
1. Use the definitions in Section of the PMBOK guide V5
to understand what processes/activities belong to each
of these process groups
2. You need not have worked on all processes on all
projects. Enter based on whatever processes you
actually worked on
3. Be brief and concise in describing the work. For
example, instead of going "This project was for a large
fortune 500 customers with revenues of ....." write
"preparing the business case for the project". Focus on
what YOU did on the project

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 Please note:
1. Total of 35 hours of education needs to be recorded
in this section.
2. Simplilearn being a REP, the PMP courses are pre-
Education approved for eligibility requirements
1. Course title
2. Institute Name Simplilearn

A: PMI register education providers. See this link to

ensure that the institute you took the course from is an
REP: http://www.pmi.org/Professional-
Development/REP-What-is-a-Registered-Education-
Provider.aspx. Please note Simplilearn is an REP
B. PMI chapters of CoP's
C. Employer/Company sponsored
D. Training companies or consultants
E. Distance learning companies
3. Category (A-F) F. University/college
4. Start date
5. End date
6. Hours
7. Qualifying hours

Inclusion in communications from PMI Select based on preferences

Optional information Enter as desired
Special accommodations If required
Language aid for examination If required
Payment Payment related information

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