TECHNICIAN CERTIFICATION PROGRAM …

1 WACEL, 7508 Wisconsin Avenue, 4th Floor, Bethesda, MD. 20814. 301-652-7925. to be typed on certificate: _____Firm: _____Address: _____Email: _____Office phone: _____Ext.: _____Home phone: _____I hereby apply for the following WACEL exam and/or class (check all that apply):Concrete Level I TechnicianSoils Level I TechnicianAggregate Lab TechnicianConcrete PracticalFoundations TECHNICIAN *Concrete Masonry Strength TechnicianReinforced Concrete Special Inspector*Fireproofing TECHNICIAN *Soils Lab TechnicianMasonry Special Inspector*Firestopping TECHNICIAN *Structural Concrete Inspector*Structural Steel TECHNICIAN Level I*Concrete Level I Review ClassSoils Level I Review ClassPlan Reading Class* Indicate Open book exams.

2 Candidates are required to bring their own reference materials for these exams to theexam venue. A list of appropriate reference materials for each exam can be found in the exam study guide available atat of WACEL testing policies and procedures: I understand and agree that as a condition of becoming aWACEL certified TECHNICIAN , that the integrity of the testing PROGRAM must be maintained at all times. I further recognizeand agree by signature below that if I am found guilty of cheating or compromising the integrity of the CERTIFICATION programby copying, photographing and/or removing tests from the testing facility or other similar actions, that I will be barred fromparticipating in the WACEL CERTIFICATION PROGRAM for a period of five years and that all existing certifications that I haveobtained will be automatically in inkThe following endorsement must be signed by a qualified supervisor.

3 (In the event the applicant is unemployed,self-employed, or employed by a nonmenber, this recommendation shall be signed and sealed by a Professional Engineerfamiliar with the applicant's capabilities. Such recommendation shall also identify the circumstances which establish it's priority).DateEndorserTECHNICIAN CERTIFICATION PROGRAM EXAMINATION APPLICATION FORMWACEL, 7508 Wisconsin Avenue, 4th Floor, Bethesda, MD. 20814. 301-652-7925. to be typed on certificate: _____Firm: _____Supervisor's name: _____Email: _____Office phone: _____Ext.: _____Home phone: _____A separate resume may be submitted in lieu of completing the following items requesting your educational backgroundand experience, providing the resume is sufficiently detailed.

4 To evaluate your application, WACEL needs to know the case of experience, for example, describe exactly the tasks with which you were involved ( "conducting slumptests and made cylinders in the field) and the degree you were (or are) personally responsible for your of school and locationDates AttendedDegree or Diploma received_____EXPERIENCEName of employer and locationEmployment DatesPosition/Title_____Duties: _____Supervisor's name and title: _____Name of employer and locationEmployment DatesPosition/Title_____Duties: _____Supervisor's name and title: _____