2012-bf-8-hour-application

1
Plumbing Heating Cooling Contractors Association Maryland Plumbing-Heating-Cooling Contractors, Inc. Suite 205, 10176 Baltimore National Pike, Ellicott City, MD 21042 (410) 461-5977 (410) 750-2507 fax R R E E G G I I S S T T R R A A T T I I O O N N F F E E E E S S : : $ $ 1 1 5 5 0 0 . . M M A A R R Y Y L L A A N N D D P P H H C C C C M M E E M M B B E E R R ~ ~ $ $ 2 2 2 2 5 5 . . N N O O N N - - M M E E M M B B E E R R B B A A C C K K F F L L O O W W R R E E - - C C E E R R T T I I F F I I C C A A T T I I O O N N C C O O U U R R S S E E A A P P P P L L I I C C A A T T I I O O N N A A C C C C E E P P T T E E D D & & A A P P P P R R O O V V E E D D F F O O R R C C E E R R T T I I F F I I C C A A T T I I O O N N I I N N T T H H E E S S T T A A T T E E O O F F M M A A R R Y Y L L A A N N D D , , W W . . S S . . S S . . C C . . & & T T H H E E C C O O M M M M O O N N W W E E A A L L T T H H O O F F V V I I R R G G I I N N I I A A June 9, 2012 Thos. Somerville Co. 1510 Tilco Drive Frederick, MD June 23, 2012 Dundalk Community College 7200 Sollers Point Road Dundalk, MD July 14, 2012 Thos. Somerville Co. 1510 Tilco Drive Frederick, MD July 28, 2012 Dundalk Community College 7200 Sollers Point Road Dundalk, MD August 11, 2012 Thos. Somerville Co. 1510 Tilco Drive Frederick, MD August 25, 2012 Dundalk Community College 7200 Sollers Point Road Dundalk, MD September 8, 2012 Thos. Somerville Co. 1510 Tilco Drive Frederick, MD September 22, 2012 Dundalk Community College 7200 Sollers Point Road Dundalk, MD October 13, 2012 Thos. Somerville Co. 1510 Tilco Drive Frederick, MD October 27, 2012 Dundalk Community College 7200 Sollers Point Road Dundalk, MD November 10, 2012 Thos. Somerville Co. 1510 Tilco Drive Frederick, MD November 17, 2012 Dundalk Community College 7200 Sollers Point Road Dundalk, MD December 9, 2012 Thos. Somerville Co. 1510 Tilco Drive Frederick, MD SCHEDULE UPDATED EVERY 30 DAYS HOURS: 7:30 a.m. – 3:30 p.m. A passing grade commensurate with National requirements on the final written examination and a satisfactory completion of the “Hands on” performance test will result in Certification. Certification is good for three (3) years. NOTE: Class schedules are updated approximately every 30 days. To reserve your space please be sure to register early. Class size is limited and applicants are accepted on a first-come first-serve basis. Name _____________________________________________________Home Phone ( ) ___________________ Address_______________________________________________ Last 4 Digits of Social Security # ____________ City______________________________________________State__________Zip Code_______________________ Certification expiration date:__________________________________ School Attended: ____________________ Company Name________________________________ Phone ( ) ________________ FAX ( )______________ Class Location request___________________________________ Class date requested_______________________ Signature of Applicant_____________________________________________________Date___________________ PAYMENT: 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 SEVEN (7) DAYS PRIOR TO THE START OF CLASS WILL FORFEIT ALL FEES.

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Page 1: 2012-BF-8-hour-Application

Plumbing Heating Cooling

Contractors Association

Maryland Plumbing-Heating-Cooling Contractors, Inc. Suite 205, 10176 Baltimore National Pike, Ellicott City, MD 21042

(410) 461-5977 (410) 750-2507 fax

RREEGGIISSTTRRAATTIIOONN FFEEEESS:: $$ 115500.. MMAARRYYLLAANNDD PPHHCCCC MMEEMMBBEERR ~~ $$ 222255.. NNOONN--MMEEMMBBEERR

BBAACCKKFFLLOOWW RREE--CCEERRTTIIFFIICCAATTIIOONN CCOOUURRSSEE –– AAPPPPLLIICCAATTIIOONN AACCCCEEPPTTEEDD && AAPPPPRROOVVEEDD FFOORR CCEERRTTIIFFIICCAATTIIOONN IINN TTHHEE SSTTAATTEE OOFF MMAARRYYLLAANNDD,, WW..SS..SS..CC.. &&

TTHHEE CCOOMMMMOONNWWEEAALLTTHH OOFF VVIIRRGGIINNIIAA

June 9, 2012 – Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD

June 23, 2012 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD

July 14, 2012 – Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD

July 28, 2012 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD

August 11, 2012 – Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD

August 25, 2012 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD

September 8, 2012 – Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD

September 22, 2012 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD

October 13, 2012 – Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD

October 27, 2012 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD

November 10, 2012 – Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD

November 17, 2012 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD

December 9, 2012 – Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD

SSCCHHEEDDUULLEE UUPPDDAATTEEDD EEVVEERRYY 3300 DDAAYYSS

HOURS: 7:30 a.m. – 3:30 p.m.

A passing grade commensurate with National requirements on the final written examination and a satisfactory

completion of the “Hands on” performance test will result in Certification. Certification is good for three (3) years.

NNOOTTEE:: Class schedules are updated approximately every 30 days. To reserve your space please be sure to register

early. Class size is limited and applicants are accepted on a first-come first-serve basis.

Name _____________________________________________________Home Phone ( ) ___________________

Address_______________________________________________ Last 4 Digits of Social Security # ____________

City______________________________________________State__________Zip Code_______________________

Certification expiration date:__________________________________ School Attended: ____________________

Company Name________________________________ Phone ( ) ________________ FAX ( )______________

Class Location request___________________________________ Class date requested_______________________

Signature of Applicant_____________________________________________________Date___________________

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 $__________.

CCAANNCCEELLLLAATTIIOONN:: 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. CCAANNCCEELLLLAATTIIOONNSS LLEESSSS

TTHHAANN SSEEVVEENN ((77)) DDAAYYSS PPRRIIOORR TTOO TTHHEE SSTTAARRTT OOFF CCLLAASSSS WWIILLLL FFOORRFFEEIITT AALLLL FFEEEESS..