/2012-BF-32-hour-Application

PLUMBING HEATING COOLING CONTRACTORS ASSOCIATION

Maryland Plumbing-Heating-Cooling Contractors, Inc. 32 HOUR BACKFLOW CERTIFICATION COURSE COST: $360. MARYLAND PHCC MEMBERS -- $450. NON – MEMBER APPROVED AS A PROVIDER OF TRAINING BY THE MARYLAND STATE BOARD OF PLUMBING ACCEPTED & APPROVED AS A PROVIDER OF TRAINING BY THE COMMONWEALTH OF VIRGINIA AND WASHINGTON SUBURBAN SANITARY COMMISSION (W. S. S. C) 32 Hour Training Course leading to Certification as a Backflow Prevention Tester/Mechanic June 8, 9, 10, 2012 Hours: 7:30 a.m. start Thos. Somerville Co. 1510 Tilco Drive Frederick, MD

June 22, 23, 24, 2012 Hours: 7:30 a.m. start.

Dundalk Community College 7200 Sollers Point Road Dundalk, MD

July 13, 14, 15, 2012 Hours: 7:30 a.m. start Thos. Somerville Co. 1510 Tilco Drive Frederick, MD

July 27, 28, 29, 2012 Hours: 7:30 a.m. start.

Dundalk Community College 7200 Sollers Point Road Dundalk, MD

August 10, 11, 12, 2012 Hours: 7:30 a.m. start Thos. Somerville Co. 1510 Tilco Drive Frederick, MD

August 24, 25, 26, 2012 Hours: 7:30 a.m. start.

Dundalk Community College 7200 Sollers Point Road Dundalk, MD

September 7, 8, 9, 2012 Hours: 7:30 a.m. start Thos. Somerville Co. 1510 Tilco Drive Frederick, MD

September 21, 22, 23, 2012 Hours: 7:30 a.m. start.

Dundalk Community College 7200 Sollers Point Road Dundalk, MD

October 12, 13 14, 2012 Hours: 7:30 a.m. start Thos. Somerville Co. 1510 Tilco Drive Frederick, MD

October 26, 27, 28, 2012 Hours: 7:30 a.m. start.

Dundalk Community College 7200 Sollers Point Road Dundalk, MD

November 9, 10, 11, 2012 Hours: 7:30 a.m. start Thos. Somerville Co. 1510 Tilco Drive Frederick, MD

November 16, 17, 18, 2012 Hours: 7:30 a.m. start.

Dundalk Community College 7200 Sollers Point Road Dundalk, MD

Scchedule updated every 30 days NOTE: To reserve your space in the class please be sure to register early. Applicants are accepted on a firstcome 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.

BOOKS. 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

MARYLAND PLUMBING-HEATING-COOLING CONTRACTORS, INC. SUITE 205, 10176 BALTIMORE NATIONAL PIKE ELLICOTT CITY, MD 21042 (410) 461-5977 FAX (410) 750-2507

32 HOUR BACKFLOW PREVENTION CERTIFICATION COURSE

COST: $360. MARYLAND PHCC MEMBER $450. NON-MEMBER APPLICATION: 1.

2.

APPLICANT please provide identification (listed below) along with your completed application and registration fees.

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:__________________________________________ 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 7 DAYS PRIOR TO THE START OF CLASS WILL FORFEIT ALL FEES.