Apply for Admission to Certification Program



In Cooperation with  









1. Complete the fields below, review the terms and conditions, and enter your name and date in the signature blocks provided

The admissions committee will review the initial application and email you instructions on how to

provide employment history, education, and references

3. Direct questions to Donald Kornblet at 314-497-1797 or



Candidate Applicant Acknowledgements and Compliance:

1. Applicant confirms that all information contained in this application is accurate to the best knowledge of the candidate.

2. Applicant acknowledges having read the following certification material at the Society of Product Safety. Professionals web site: 1) Scope of Knowledge of the Certification Program, 2) Certification Program Course details, and 3) Participant Guidelines for the Certification Program, and understands the criteria for acceptance into the program.

3. Receipt of this application does not constitute acceptance into the Certification Program. Candidates
must be approved by the Program Admission Committee which will formally notify all applicants of
their status once determined.

4. Candidate understands and accepts that the decision of the Admissions Committee is final. Acceptance into the program is limited to admission in the upcoming Certification course only and may not be deferred for entry into a future offering of the program.

5. Candidate understands that enrollment in the certification course will be limited to 30 participants, and that, if accepted, the completed registration should be finalized in a timely manner.

6. Upon acceptance into the course, candidate or their employer will be responsible for payment of the
course tuition fee unless arrangements have been approved by Society of Product Safety Professionals.

7. The application fee of $175 is non-refundable and covers costs associated with the application process, including the services of a third party independent verification service to confirm employment and education background.

8. Candidate understands that the Certification Course is being offered by Virginia Tech and administered by the Society of Product Safety Professionals in cooperation with ADK Information Services LLC. For information on privacy policies please see: ADK Information Services LLC. Privacy Policies


March 22 - June 7, 2023
Virginia Tech Research Center
900 N. Glebe Road
Arlington, Virginia
INFO:   Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and/or are not selectable.

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Registrant Fee: $0.00

Billing information

Billing and Payment
Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*ADKINFORMATIONSERVIC 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

Applicant Signature
Please enter your full name in the space below.

Please click the button below to finalize your registration.

Registration inquiries:
Program Coordinator
Society of Product Safety Professionals
ADK Information Services
(314) 497-1797
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Privacy Policy
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use this registrant for billing information
These terms and conditions apply between Society of Product Safety Professioinals and ADK Information Services, LLC, known as "Organization" in this document, and those persons registering for and participating in the Organization's' application process ("Applicant").

a. Registration is on a first-come, first served basis. Early registration helps to ensure availability. Organization reserves the right to substitute speakers, presenters, facilities, venue and/or any program to be offered at the Event at any time. By registering for this Event, Applicant represents, warrants and ensures that he/she is physically and mentally able to participate in the program for which he/she is registering and/or any others in which Applicant may participate. Applicant understands that this registration is non-transferrable and non-assignable and that any other person(s) wishing to attend the event must register in their own name(s). If you have any questions concerning the Event, please contact the Organization directly.

b. By registering for this Event, Applicant agrees to fully and completely comply with all terms and conditions hereof and the Organization's rules and regulations. Organization reserves the right to refuse attendance to any individual at any of its Events. All packages, bags, and other containers brought to the Event are subject to search, and may be required to be stored during the Event. Failure to comply with the Organization's rules and regulations is grounds for immediate dismissal from the Event. Persons dismissed from the Event shall not be entitled to a refund or cancel any unpaid balance due. Applicant's failure or inability to use all of the facilities, classes or services offered at the Event for any reason, except as otherwise provided herein does not relieve or suspend the Applicant's obligation to make all payments required hereunder on a timely basis, nor entitle the Applicant to a refund or credit. Applicant understands and agrees that payment for the Event is not a guarantee or promise of satisfaction.

2. BILLING AND PAYMENT: Billing and payment processing for Organization's events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Applicant knowingly and irrevocably authorizes MSI to charge electronically Applicant's bank account and/or credit card for any and all amounts due for Applicant's, and anyone registering under Applicant's, attendance and participation in the Event. Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Applicant. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

3. SIGNATORIES. Any person(s) signing this agreement, whether as an Applicant, co-signer or otherwise shall be jointly, severally and individually liable to Organization, and MSI for the full contract price as if such person signed as the Applicant. All persons signing this agreement assume responsibility for all costs of collection, including but not limited to collection agency fees, court costs, attorney's fees, and late charges that may be incurred in the event of a default. Any person (s) signing this agreement authorizes the use of a disclosed e-mail address for billing purposes and acknowledges that e-mail text may include financial information pertaining to the membership. Any person signing this agreement authorizes the use of a disclosed cell phone or telephone number for autodialed or pre-recorded voice calls and text messages for billing related issues including, but not limited to, expiring billing information, or overdue account balances.

4. APPLICANT'S RIGHT TO CANCEL: If you wish to cancel your registration, you may cancel by delivering or mailing by certified mail, return receipt requested, written notice to MSI and Organization. If your notice of cancellation is received more than 10 days prior to the Event, no administrative fee will be charged. Any cancellation received 10 days or fewer before the Event shall result in a per person administrative fee equal to the lesser of $25 or 30% of the Event cost. MSI is not responsible for any refunds. Applicant further agrees that once the registration is submitted, this Agreement is a legally binding and enforceable obligation of Applicant.

5. RELEASE; INDEMNIFICATION: Applicant understands and agrees that his/her participation in and attendance at the Event is knowing and voluntary. Applicant understands and agrees that strict observation of the Event rules and regulations is required and that use of the Event facilities and the Applicant's presence at the Event are at the sole risk of the Applicant. Applicant indemnifies and holds harmless Organization and MSI, and their officers, directors, employees and agents from and against any claims, demands, actions, liabilities, damages, costs or expenses, including court costs and reasonable attorneys' fees arising out of or relating to: (i) Applicant's participation in the Event; (ii) claims against Organization and/or MSI by any third parties arising from or related to Organization's or MSI's actions and/or omissions, (iii) claims relating to any violation or alleged violation by Organization and/or MSI and/or any third party of the applicable laws relating to the conduct of the Event; and/or (iv) claims arising from or relating to Organization's and/or MSI's performance of its obligations hereunder. Applicant specifically understands and agrees that he/she is assuming the risk of any and all injuries that he/she may suffer or incur as a result of his/her registration and/or participation in the Event. Applicant's indemnification obligations shall survive the expiration or termination of this agreement.

6. COPYRIGHT; USE OF IMAGES: This Event is copyrighted by Organization. Video, audio and/or any other means of recording of this Event by Applicant are strictly prohibited. Violators will be dismissed from the Event and Organization reserves all legal rights to pursue civil remedies. To inquire about obtaining a professional recording of the Event, please contact Organization. Applicant, for him/herself and his/her/its officers, directors, employees, agents, representatives, successors, assigns, heirs, executors and administrators hereby irrevocably consents to the unrestricted use by Organization, its advertisers, clients, customers, successors and assigns, of Applicant's name, likeness, statements, photograph or motion picture, for advertising, sale, marketing, promotion or any other purposes of trade and Applicant waives the right to inspect or approve such completed images used in connection therewith. Applicant grants to Organization the exclusive right to exploit and license or assign for exploitation all such matter or any approved derivatives thereof in any manner in any medium or field of use, in the form delivered.

7. UNAVAILABILITY; FORCE MAJEURE: Organization will use commercially reasonable efforts to hold the Event. However, under no circumstances will Organization be held responsible for unavailability caused by circumstances beyond Organization's reasonable control, including acts of God, acts of government, flood, fire, earthquakes, civil unrest, acts of terror, strikes or other labor problems nor can any reservation be cancelled, altered or amended once the Event has commenced on the basis of circumstances beyond Business' reasonable control.

8. COMPLIANCE WITH LAWS: This Agreement shall be governed by the laws of Missouri. All rights and obligations of the Organization and Applicant under this Agreement are subject to all applicable federal, state and local laws and regulations. These terms and conditions shall be deemed revised to conform to applicable statutes, rules and regulations. Organization and/or MSI may modify the terms and conditions stated herein at any time in their sole and absolute discretion. Customer shall be bound by the modified Agreement and agree that no other modifications shall be enforceable. This Agreement constitutes the entire Agreement between the parties and supersedes all prior agreements between the parties, whether written or oral. The invalidity or non-enforcebility of any provision hereof shall not affect the validity or enforceability of any other provision. The waiver of any breach shall not constitute a waiver of any subsequent breach.
Check this box to indicate that you have read and agree to all of the above terms & conditions