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Please print, complete (in legible black ink printing), & sign this PCI
training application, along with
the
P.C.I. Code of Ethics, scan both documents, and then email both
this application and the signed
Code of Ethics to P.C.I. by email attachment to:
moldconsultant@yahoo.com,
or FAX to 63-35-226-3219.
Full
name:_______________________________________________________________________________________________
Mailing
address:__________________________________________________________________________________________
City:_______________________________ State: __________________ Postal
Code: __________ Country:______________
Daytime phone: (________ )_____________________ Evening phone: (________
)_____________________
Email
address:______________________________________________________________________________
Designation(s)
I desire (upon successful completion of each certification designation
training program, which can be done simultaneously with one another):
____
Certified Mold Inspector and Certified Mold
Remediator combination
--
tuition US$998 for both PCI
professional designation certifications Certified Mold Inspector and
Certified Mold Remediator, plus US$198 first year PCI certification
membership dues total for both designations, for a total of US$1,196.
____
Certified
Environmental Hygienist--tuition
$999.00 plus first year membership certification dues in PCI of $99.00 for
a total of $1,098.00.
____
All three Certifications
in one Money-Saving Combination. Be trained and Certified as Certified
Mold Inspector, Certified
Mold Remediator, and Certified Environmental Hygienist for only
US$1,999.00 including first year PCI Certification membership dues a
saving of US$295.
All payments are in US$.
If I
am accepted by the Professional Certification Institute, I, and the
organization that I may represent, will always follow and abide by
the
Code of Ethics of P.C.I. I understand and agree that my
professional designations will be terminated if I violate the
Code of Ethics, or if I do not pay my annual renewal PCI membership
dues (currently $99.00 per certification designation). To accompany this
training application, I will make payment to PCI by using one of the
PayPal payment links at the top of the
home page,
or by my personal or business check, or money order payable to the
Professional Certification Institute.
If
you have completed ANY post-high school college, trade, or
technical education programs of any kind, please provide the details
including school name, school location, year of graduation or completion
of course, subjects studied, and any other helpful info. Attach extra
sheets of paper if needed.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Please describe in detail all or your business/work/career experiences
that you believe would be helpful to your successful career as a
certified environmental professional. [please include details such as
skills learned, employer names and addresses, and dates]. Attach
extra sheets
of paper if needed.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Please provide the names, nature of relationship [how you know each
person], company [if relevant], complete mailing address, and current
phone number of three persons who personally know your work abilities
and/or general character. Your most ideal references would be
your business/
professional clients or co-workers. Please do NOT submit references who
are your relatives or employees. Attach extra sheets if needed.
___________________________________________________________________________________________________
__________________________________________________________________________________________________
___________________________________________________________________________________________________
I
certify that the above information is totally true and complete. I
authorize my references to provide complete information about myself
to the Professional Certification Institute.
__________________________________________
____________________
My
Signature
Date
.............................................
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