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Shotcrete Nozzleman Education \ Certification Session Request Form
Session Type:
Wet MixDry Mix
Preferred Session Start Date:
Session Location (City, State, Country):
Session Host Organization/Company Name:
ASA Corporate Member?:
Yes(if yes is selected, supply member number)No
Host’s Physical Address (No P.O Boxes Please):
Host’s City:
Host’s State:
Host’s Zip/Postal Code:
Organizer (The single person identified by the Host as the coordinating contact):
Organizer’s Telephone:
Organizer’s E-mail:
Session Services
Education Session An Education session must be taken by all participants except those that have already participated in an ASA Education session and are now retesting or recertifying. ASA recommends a full day Education Session.
First Time Certification Nozzlemen seeking certification for the first time must submit 500 hours of documented nozzleman experience before they will be allowed to participate in an exam.
Vertical Performance Exam
# of examinees in English:
# of examinees in Spanish:
Overhead Performance Exam
Written Exam
Recertification Two options are available for nozzleman seeking recertification: Pass the applicable performance exam(s) and pass the written exam. No work experience documentation is required under this option. Pass the applicable performance exam(s) and Submit 1000 hours of documented nozzleman experience for the two years immediately prior to seeking recertification. No written exam is required under this option.
NOTE 1: Examinees that cannot provide 1000 hours of documented nozzleman experience for the two years immediately prior to seeking recertification are required to pass a written exam
Retest
Required Special Accommodations
Examinee(s) will require oral testing for written exam
If you have a examinee with a disability that may impact their participation in this activity, please include below a statement regarding your disability-related needs. You will be contacted prior to the program to discuss accommodations. We cannot assure the availability of appropriate accommodations without prior written notification of need.
Note: Certification in the overhead position requires successful completion of both the vertical and performance exams. Please contact ASA at 248/848-3780 with any questions regarding this form or the education/certification program in general.