Part 1: Exam Application

When filling out the application: Please complete all sections of the application. You may optional complete the survey in section 2. It is necessary to provide complete information as requested. Incomplete information may result in ineligibility to sit for the examination or withholding of scores. It is your responsibility to notify the APENS Committee of any change in the information on this application within 3 days of when that change occurs.

Reminder: Upon passing the examination, you will need to submit additional information to receive certification, including: part two of the application, a copy of current teaching certification in physical education, verification of at least 200 hours of experience teaching physical education directly to individuals with disabilities, and official transcripts from each college/university attended. Part One and Part Two may be submitted simultaneously, if desired.

When submitting the application: Please include with this application all materials listed on the application checklist. The completed application must include the $250.00 examination fee. Your check or money order should be made payable to APENS. Applications received after the submission deadline will only be processed for the following examination. Forward this application only to the address shown below:

The APENS Committee reserves the right to reject any application that does not meet eligibility criteria
as documented in this application.

APENS Nondiscrimination Policy: It is the policy of the APENS Committee and the National Consortium for Physical Education and Recreation for Individuals with Disabilities (NCPEID) to comply with all applicable laws which prohibit discrimination in the employment or service provision because of a person’s race, color, religion, gender, age, disability, national origin, or because of any other protected characteristic.

Attn. Timothy. D. Davis, Ph.D. CAPE
1106 Park Center
SUNY Cortland
P.O. Box 2000
Cortland, NY 13045

Section 1: Personal Information

Site Selection: Please select your first, second, and third choice for examination locations:

First Name:   Middle Intial:   Last Name:
If your school records are under another name (i.e., maden name),
please enter it here
Street Address:   City:   Zip Code:
School District:
Home Phone: Work Phone: Fax Number:
Date of Birth:   Email Address:
How will you be paying for the exam?

If paying through your school, employer, or a grant, please specify the name of the payment source (i.e., your teacher's name and the school you attend)
Are you requesting special arrangements due to a physical or cognative impairment or religious resaouns? 

If yes, APENS policy is that: Any individual who has a physical or cognitive impairment or limitation that prevents him/her from taking the test under standard conditions may request special testing arrangements. The types of accommodations that may be provided include large print, a person to read and/or mark the answer sheet, extended time, and/or a separate testing room. Documentation from a physician or appropriate authority is required to confirm your special needs and testing adaptation request. This documentation should be mailed with your test registration form to the APENS office.

When submitting application/registration forms, Please be sure to complete the provided "additional information" text field below and describe:
a) your disability or special need and b) the adaptations being requested

If religious beliefs prohibit an individual from taking the examination on a Saturday, an alternate day may be requested. The application must be accompanied by a letter of confirmation from the individual’s clergy. After reviewing requests, the testing coordinator will send a letter confirming any special arrangements. There are no charges for these special arrangements.

Additional Information:


SECTION 2 - Application and Examination Terms THIS SECTION MUST BE SIGNED IN ORDER FOR YOUR APPLICATION TO BE PROCESSED I hereby authorize the APENS Committee, the NCPEID and their officers, directors, committee members, employees, and agents to review my application to sit for the APENS certification examination. I authorize the proctors at my assigned test site to maintain a secure and proper test administration in their discretion. I acknowledge that in this capacity the proctors may relocate me before or during the examination. I will not communicate with other examiners in any way during the examination.

If I do anything which is not authorized or which is prohibited by the APENS Committee or NCPEID in connection with any APENS examination, I understand that my examination performance may be voided, and such activity may be the subject of legal action. In a case where my examination performance is voided, I will not receive a refund of the application fee, there will be no credit for any future examination, and such activity may be cause for review under or subject to other legal action. I understand that the APENS Committee reserves the right to refuse admission to any APENS examination if I do not have the proper identification (authorization letter and photo ID), or if administration has begun. If I am refused admission for any of these reasons or fail to appear at the test site, I will receive no refund of the application fee or examination fee and there will be no credit for future examinations. I understand that I may only seek admission to sit for the APENS examination for the purpose of seeking APENS certification, and for no other purpose. I will not disclose any information regarding the content of the examination, test questions, or test materials.

I understand that the review of the adequacy of examination materials will be limited to computing any scoring correction. I waive all further claims of examination review and agree to indemnify and hold harmless the above designated parties for any action taken pursuant to the rules and standards of the APENS Committee with regard to this application and/or the APENS examination.

I acknowledge that I have read and understand this information, and agree to abide by these terms.

The National Standards for Adapted Physical Education Project was funded by the United States Department of Education, Office of Special Education and Rehabilitation Services, Division of Personnel Preparation: (1992-1997) #HO29K20092. The views expressed are those of the grantee, the University of Virginia. No official endorsement by the U.S. Department of Education is intended or should be inferred.