CFPM Initial Application
CERTIFIED FOOD PROTECTION MANAGER (CFPM)
Applicant information
Name ________________________________________________________________________
Last First Full middle name
Mailing address ________________________________________________________________
Street Apt. (if applicable)
________________________________________________________________
City State ZIP County
Social security number* ______________________________
*Required under Minnesota Statutes, section 270C.72, subdivision 4
Contact phone ______________________________________
Applicant email _____________________________________
Preferred method to receive renewal notifications
Mailing address Applicant email
Submit application
Before mailing, be sure to include the following
1. Completed and signed application form
2. Copy of your exam certificate
3. Check or money order made payable to MDH for $35 –
NO CASH, CREDIT or DEBIT CARDS ACCEPTED.
Mail to
Minnesota Department of Health
Certified Food Protection Manager
Food, Pools, and Lodging Services Section
PO Box 64495
St. Paul, MN 55164-0495
Minnesota Statute 157.16, Subd. 2a. states, an applicant for certification or renewal certification
must submit a $35 fee. This fee is nonrefundable.
Approved exams
The applicant for initial certification as a CFPM shall complete a training course and pass an
approved examination. The examination cannot be older than 6 months at the time of application. If
the exam certificate is older than 6 months old, the applicant shall retake the initial course and pass
the exam again before certification can be granted.
If you no longer have the exam certificate, first try to get a copy of the certificate or other proof of
having passed the exam from the organization, company or school that conducted the course of the
exam you took. If that does not work, contact the organization that provided the exam.
Applicants for initial certification must provide proof they have passed an exam from an
organization accredited by the ANSI-CFP Accreditation Program.
For Office Use Only:
Date Received: ___________
Amount: $__________
Check #: ___________
Approved: Yes_____ No_____
CFPM INITIAL APPLICATION
2
Individuals applying for CFPM in the State of Minnesota
The commissioner of health will use information provided in this application to determine if you
meet the requirements for certification. Submitting false information is grounds for denying your
application or suspending, revoking or taking other disciplinary action against your certificate, if
issued. Failure to provide required information may delay the processing of your application and
may be grounds for denying your application.
For information on licensing data see Minnesota Statutes, section 13.41.
Notice: The issuance of a dishonored check to this department will require a service charge of $30
per check as in Minnesota Statutes, section 604.113, subd.2 (a). Additional civil penalties may be
imposed for non-payment.
I certify that the information provided and submitted on this application is accurate and complete.
Signature ____________________________________________ Date ________________________
Resources
Initial Minnesota CFPM
(https://www.health.state.mn.us/communities/environment/food/cfpm/howto.html)
ANSI-CFP Accreditation Program
(https://www.ansi.org/Accreditation/credentialing/personnel-certification/food-protection-
manager/ALLdirectoryListing?menuID=8&prgID=8&statusID=4)
Minnesota Department of Health
Food, Pools, and Lodging Services Section
651-201-4500
health.foodlodging@state.mn.us
www.health.state.mn.us
January 2022
To obtain this information in a different format,
call: 651-201-4500.
