Transfer to NCOPE National Commission on Orthotic and Prosthetic Education (NCOPE)

Verification of Residency Completion & Certificate Reprint Request Form

Verification of Residency &
Certification of Completion Request Form

REQUEST FOR CERTIFICATE OF COMPLETION/STATE LICENSURE VERIFICATION FORM
NCOPE charges $25.00 dollars for state licensure residency completion verification letters and $10.00 dollars for residency completion certificate reprints (all residents will receive one complimentary certificate of completion when their residency program is completed) Please do not send cash. NCOPE accepts credit card, check, and money order payments. The credit card payment form is located just below the request form. Make checks and money orders payable to NCOPE. Completed forms with payment can be mailed to NCOPE or faxed if payment is by credit card. The eFax number is: 1-703-890-2425. Requests can take up to 2 weeks to process. All state licensure verification letters will be sent certified mail directly to state licensure agency and a copy the letter will be mailed to the requester. **Effective January 1, 2018: verification of residency completion letter fee will be $30.00 dollars and reprints of residency certificate of completion will be $20.00 dollars each.
Residency Information

Request Summary
(please check all that apply)
Rate Quantity Costs

$25.00
$10.00
Total
For Office Use Only


Fill Out and Print the Credit Card Payment Form Here

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