American Shotcrete Association


Shotcrete Nozzleman Education \ Certification Session Request Form

Request To:


Session Type:


Preferred Session Start Date:

Session Location (City, State, Country):

Session Host Organization/Company Name:

ASA Corporate Member?:


Wait List requester, please fill out this section with your information

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.

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Recertification
Two options are available for nozzleman seeking recertification:

  1. Pass the applicable performance exam(s) and pass the written exam. No work experience documentation is required under this option.
  2. 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.

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Retest
Current applicants requiring retesting on a failed exam.

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Required Special Accommodations

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 overhead performance exams.

Please contact ASA at 248/848-3780 with any questions regarding this form or the education/certification program in general.