Cert App - CP3 TECHNOLOGIST -Updated Jan 2009

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1、CathodicProtectionCertificationApplicationCP3-CathodicProtectionTechnologist(MustbesubmittedtoNACEHeadquartersforcertificationtobeprocessed)PleaseNote–ThisIsNotAClassOrExamRegistrationNACEMember:¨Yes¨NoMember#Applicant'sName:HomeAddress:CompanyName:CompanyAddress:Country

2、:Zip/PostalCode:Phone:HomeBusinessFaxE-mail:_____________________________SIGNATURE:DATE:PRINTEDNAME:REQUIREMENTSNECESSARYTOACHIEVECERTIFICATIONToachievethiscertification,qualifiedindividualshavetwooptions(seeeachoptionforprerequisites):CLASSROOMTRAINING–CP3-CathodicProte

3、ctionTechnoloistorEXAMONLYOPTION-CP3-CathodicProtectionTechnologistExamOnlyAPPLICATIONPROCEDUREItisstronglyrecommendedthatExamOnlycandidatessubmitacompletedapplicationforcertificationatleast60daysinadvancesothatworkexperiencerequirementsandeducationprerequisitescanbeveri

4、fied.RECERTIFICATIONREQUIREMENTSEverythree(3)years.Recertificationrequiresaminimumof2yearsworkexperienceincathodicprotectionand8hoursperyear(24hrstotal)ofprofessionaldevelopmenthours.SUBMITCOMPLETEDAPPLICATIONANDSIGNATUREPAGESTO:MAILTO:NACEINTERNATIONALORFAXTO:281-228-63

5、11CERTIFICATIONDEPARTMENT1440SOUTHCREEKDRIVEHOUSTON,TX77084Ifyouhaveanyquestions,pleasecontactMarieNewtoninourCertificationdepartmentat281-228-6211orbye-mailatmarie.newton@nace.org.AFFIRMATIONIaffirmthat:1.IunderstandthatIamsolelyresponsibleformakingsurethatallnecessaryw

6、orkexperiencedocumentationiscompleteandsubmittedingoodordertoNACEHeadquarters.Q/CERTIFICATION/CERTIFICATIONAPPLICATIONS/CP2TECHNICIAN-UpdatedJan20071.IunderstandthatifIknowinglyprovide,orcausetobeprovided,anyfalseinformationinconnectionwithmyrecognitionundertheNACEIntern

7、ationalTrainingandCertificationProgram,thatitwillbegroundsforactionagainstmyunderstandingintheprogram.3.IunderstandthatthenamesofthecategorieswithintheNACEInternationalCathodicProtectionTrainingandCertificationProgramareasfollows:HighestLevelSuccessfullyCompletedCategory

8、NameCP1CP1-CathodicProtectionTesterCP2CP2-CathodicProtectionTechnicianCP3CP3-CathodicProtectionTechnolo