US Certification Examination Retake – Designated Proctor

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$100.00

The following person meets Ecopliant Environmental, Inc.’s proctor criteria as found at www.cisecinc.org and has agreed to administer my examination. It is my understanding this option requires a $50 administrative fee for the Examination and $50 Proctor Fee (total of $100) as well as Ecopliant Environmental, Inc. approving, and receiving a signed contract from, the proctor.

PDH/CDH Notice

All CISEC Registrants must submit an annual renewal payment, at least 12 Professional Development Hours/Continuing Development Hours (PDH/CDHs), and a Re-Certification Contract by your renewal date of each year. Select from the following PDH/CDH sections and add descriptions and applicable files as necessary.

Inspection Related Activities

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Inspection Related Activities

Inspection Related Activities

Identify the number of hours you completed construction site inspection related activities (maximum of 8 PDH/CDHs/yr).

(max file size 100 MB)
(max file size 100 MB)
(max file size 100 MB)

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Volunteer Related Activities

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Volunteer Related Activities

Volunteer Related Activities

Describe your environmental volunteer activities (e.g., proctoring, trash planting trees, clean up, serving as a board member, etc.) and identify the number of hours spent (maximum of 6 PDH/CDHs/yr.).

(max file size 100 MB)
(max file size 100 MB)
(max file size 100 MB)

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Professional Forums

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Professional Forums

Professional Forums

Identify and describe the professional forums you attended (e.g., IECA, StormCon, APWA, etc.), provide proof of registration (e.g., name tag, registration form), and identify the number of attendance hours (maximum of 8 PDH/CDHs/yr.).

(max file size 100 MB)
(max file size 100 MB)
(max file size 100 MB)

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Educational Forums

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Educational Forums

Educational Forums

Identify educational forums you attended (e.g., Inspecting DOT projects, How to Write a SWPPPs, etc.) and provide copies of certificates that clearly illustrate the PDU and/or CEU hours earned (maximum of 8 PDH/CDHs/yr.).

(max file size 100 MB)
(max file size 100 MB)
(max file size 100 MB)

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Technical Papers

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Technical Papers

Technical Papers (Presenting or Publishing)

Identify the title, when and where it was presented or published, and provide a copy of the technical paper (maximum of 2 PDH/CDHs/yr.).

(max file size 100 MB)
(max file size 100 MB)
(max file size 100 MB)

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Other Activities

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Other Activities

Other Activities

Describe other activities for which you want Ecopliant Environmental, Inc. to consider as being eligible for CDHs (Maximum of 8 PDH/CDHs/yr.) Please list title, date, and hours.

(max file size 100 MB)
(max file size 100 MB)
(max file size 100 MB)

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