2012-bf-32-hour-application

PLUMBING HEATING COOLING

CONTRACTORS ASSOCIATION

Maryland Plumbing-Heating-Cooling Contractors, Inc.

3322 HHOOUURR BBAACCKKFFLLOOWW CCEERRTTIIFFIICCAATTIIOONN CCOOUURRSSEE

CCOOSSTT:: $$336600.. MMAARRYYLLAANNDD PPHHCCCC MMEEMMBBEERRSS ---- $$445500.. NNOONN –– MMEEMMBBEERR

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32 Hour Training Course leading to Certification as a Backflow Prevention Tester/Mechanic

June 8, 9, 10, 2012 June 22, 23, 24, 2012 July 13, 14, 15, 2012 July 27, 28, 29, 2012

Hours: 7:30 a.m. start Hours: 7:30 a.m. start. Hours: 7:30 a.m. start Hours: 7:30 a.m. start.

Thos. Somerville Co. Dundalk Community College Thos. Somerville Co. Dundalk Community College

1510 Tilco Drive 7200 Sollers Point Road 1510 Tilco Drive 7200 Sollers Point Road

Frederick, MD Dundalk, MD Frederick, MD Dundalk, MD

August 10, 11, 12, 2012 August 24, 25, 26, 2012 September 7, 8, 9, 2012 September 21, 22, 23, 2012





October 12, 13 14, 2012 October 26, 27, 28, 2012 November 9, 10, 11, 2012 November 16, 17, 18, 2012





Scchheedduullee uuppddaatteedd eevveerryy 3300 ddaayyss NOTE: To reserve your space in the class please be sure to register early. Applicants are accepted on a first-

come first serve basis. Call (410) 461-5977 for a new schedule.

Re-Certification schedules are available by calling the MPHCC office at (410) 461-5977. Re-certification classes are offered

at all of the above listed locations.

The Maryland State Board of Plumbing requires the successful completion of an approved 32 Hour Backflow

Training Course as a pre-requisite for the Journey/Master Plumber examination. The focus of this course shall

be to develop a working knowledge of the causes and principles of the backflow and backflow prevention.

Recognizing proper backflow prevention assembly application and operation is stressed. A complete

understanding and ability to perform accepted field test procedures for all backflow prevention assemblies are

required for Certification.

BBOOOOKKSS.. The University of Florida (TREEO) Backflow Prevention Theory and Practice book is used in the

course and is included in the cost of registration.

CERTIFICATION. A passing grade on the final written examination and a satisfactory completion of the “hands

on” performance will result in Certification. Certification is good for three (3) years. If you fail the course and

are required to re-test you will be notified by the office.

REGISTRATION: Applicants are accepted on FIRST-COME FIRST-SERVE basis. Class size is limited to 15

persons.

PAYMENT MUST ACCOMPANY APPLICATION. We Accept the credit cards listed below.

American Express VISA MasterCard

PLUMBING-HEATING-COOLING

CONTRACTORS ASSOCIATION

MMAARRYYLLAANNDD PPLLUUMMBBIINNGG--HHEEAATTIINNGG--CCOOOOLLIINNGG CCOONNTTRRAACCTTOORRSS,, IINNCC.. SSUUIITTEE 220055,, 1100117766 BBAALLTTIIMMOORREE NNAATTIIOONNAALL PPIIKKEE

EELLLLIICCOOTTTT CCIITTYY,, MMDD 2211004422

((441100)) 446611--55997777 FFAAXX ((441100)) 775500--22550077

3322 HHOOUURR BBAACCKKFFLLOOWW PPRREEVVEENNTTIIOONN CCEERRTTIIFFIICCAATTIIOONN CCOOUURRSSEE

CCOOSSTT:: $$336600.. MMAARRYYLLAANNDD PPHHCCCC MMEEMMBBEERR $$445500.. NNOONN--MMEEMMBBEERR

APPLICATION:

1. APPLICANT please provide identification (listed below) along with your

completed application and registration fees.

2. ATTENTION: PLEASE PROVIDE THE FOLLOWING IDENTIFICATION WITH YOUR

APPLICATION

APPRENTICES - Copy of a valid Maryland Apprentice Plumber License.

JOURNEY - Copy of a valid Maryland State Journey License.

MASTER PLUMBERS - Copy of a valid Maryland Master Plumber License.

WSSC - OUT OF STATE PLUMBERS - Copy of your WSSC or State License

STATE/FEDERAL GOVERNMENT - Copy of State/Federal issued ID card.

Name_________________________________________ Home Phone: ( )_______________________

Home Address ___________________________________Last 4 Digits of Social Security No._________

City _________________________________________ State __________ Zip Code _________________

Signature: ___________________________________ Work Phone: ( ) _________________________

Company Name: ______________________________ Fax Number: ( ) _______________________

Class Location Requested:__________________________ Class Date: ____________________________

Enclosed is my check made payable to Maryland PHCC in the amount of $__________.

Credit Card # _________________________ Expiration Date:__________ Security Code_____________

Name as it appears on Credit Card________________________________________________________

Billing address for credit card____________________________________________________________

Street City State Zip Code

AUTHORIZED SIGNATURE OF CARDHOLDER:__________________________________________

PPAAYYMMEENNTT:: Please make check payable to Maryland PHCC. Payment must accompany the

completed application. Mail to: Maryland PHCC, Suite 205, 10176 Baltimore National Pike, Ellicott

City, MD 21042. Enclosed is my check in the amount of $__________.

CANCELLATION: WHAT IF I NEED TO CANCEL? APPLICANTS WHO CANCEL UP TO 10 DAYS PRIOR TO THE

START OF THE COURSE WILL FORFEIT 25% OF THE TOTAL FEE TO COVER ADMINISTRATIVE FEES.

CANCELLATIONS LESS THAN 7 DAYS PRIOR TO THE START OF CLASS WILL FORFEIT ALL FEES.

2012-bf-32-hour-application

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