CEU FORM

IGSHPA Continuing Education Credit Form

Accreditation for IGSHPA accredited installer and accredited vertical loop installer is valid for three years. During those three years an installer must accumulate nine points to renew accreditation. The points can be accumulated in three ways – through employment, memberships in geothermal industry related organizations and/or education. Please complete sections as they apply to your accreditation renewal.

Information

Required fileds are marked with an asterisk *

Name of Applicant*

Accreditation Number*

Email* (required)

Phone*

Session 1 : Employment

The installer may accumulate up to 4 points by remaining continually employed for three years in the combined geothermal heat pump installation, heating, ventilation and air-conditioning field. For those with less than three years of employment, points are accumulated at the rate of 1.33 points per year

Employer 1

Date of Employment1 (To / From)

Employer1's Address

Number of Points (4 points maximum) 1

Employer 2

Date of Employment2 (To / From)

Employer2's Address

Number of Points (4 points maximum) 2

Total Number of points for Section 1 (4 points maximum)

Section 2. Membership

The installer may accumulate up to 4 points by continuous membership in geothermal industry-related organization(s). The points are accumulated 1 point per year of membership since the last accreditation renewal. Membership in more than one organization will apply toward accumulation of multiple points per year. Acceptable organizations include BUT ARE NOT LIMITED TO: NGWA, GEO, ASHRAE and AEE.

Organization

Years of Membership (To / From)

Number of Points (3 points maximum)

Organization 2

Years of Membership 2

Number of Points 2(3 points maximum)

Total Number of points for Section 2 (4 points maximum)

Section 3. Education

The installer may accumulate points by attending training courses, workshops or conference technical seminars/sessions in the geothermal heat pump, drilling or HVAC fields. Points are accumulated at 0.1 points per contact hour, professional development hour or learning unit. Vocational school or college courses earn 2 points for each credit hour. There is no limit on point earnings through education.

Training Courses, Workshops, Sessions or Seminars

Seminar/session/workshop/course name

Conference Name (if applicable)

Date(mm/dd/yyyy)

Location

Length (number of contact hours)

Number of Points (contact hours x 0.1)

Seminar/session/workshop/course name 2

Conference Name 2(if applicable)

Date 2(mm/dd/yyyy)

Location 2

Length (number of contact hours) 2

Number of Points2 (contact hours x 0.1)

Total Number of points for Section 3

POINTS:

Employment

Membership

Education

Total Points (9 points required)