Maryland Plumbing-Heating-Cooling Contractors, Inc. 10176 Baltimore National Pike, Suite 205 Ellicott City, MD 21042-3652 (410) 461-5977 fax (410) 750-2507 e-mail: phccmd@aol.com
REGISTRATION FEES: $ 150. MARYLAND PHCC MEMBER ~ $ 250. NON-MEMBER
BACKFLOW RE-CERTIFICATION COURSE – APPLICATION ACCEPTED & APPROVED FOR CERTIFICATION IN THE STATE OF MARYLAND, W.S.S.C. & THE COMMONWEALTH OF VIRGINIA January 7, 2017 - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD January 21, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD February 4, 2017 - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD February 18, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD March 4, 2017 - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD March 18, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD April TBD - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD April 22, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD May TBD - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD May 20, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD June TBD - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD June 24, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD July TBD - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD July 22, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD August TBD Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD August 19, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD September TBD - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD September 23, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD October TBD - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD October 21, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD November TBD - Thos. Somerville Co. – 1510 Tilco Drive – Frederick, MD November 18, 2017 – Dundalk Community College – 7200 Sollers Point Road – Dundalk, MD
FOR SCHEDULE UPDATES CONTACT THE OFFICE (410) 461-5977 HOURS: Starting time for this course 7:30 a.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: _____________________ e-mail address________________________________________ Company Name______________________________________ (
) ________________ FAX (
)______________
Class Location request___________________________________ Class date requested _______________________ Signature of Applicant_____________________________________________________Date____________________ PAYMENT: Payment must accompany the completed application. Please make check payable to Maryland PHCC and 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 (5) DAYS PRIOR TO THE START OF CLASS WILL FORFEIT ALL FEES.