ࡱ> ] bjbj 4Vx-\x-\ RRRRRfff8,fA~@@@@@@@$BoE@RP"P"P"@RR@%%%P"pRR@%P"@%%Rj=?P?"v^>z@@0A|>7F6#P7F<?7FR?d%@@%dAP"P"P"P"7F > :  STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF LABOR AND TRAINING DIVISION OF WORKFORCE REGULATION AND SAFETY RENEWABLE ENERGY PROFESSIONAL CERTIFICATE OR SOLAR THERMAL PROFESSIONAL CERTIFICATE *** INSTRUCTIONS PLEASE READ CAREFULLY *** APPLICATIONS WILL NOT BE REVIEWED BY THE DEPARTMENT OF LABOR AND TRAINING IF THE FOLLOWING DIRECTIONS ARE NOT ADHERED TO: A legible copy of Driver License or Passport or any type of Government ID MUST be attached. Your application must be signed and notarized. In accordance with the General Laws of the State of Rhode Island, (H-8200, S-2692); the Department of Labor and Training will issue a Renewable Energy Professional (REP) Certificate to an individual who is currently a registered contractor in Rhode Island and fulfills at least one of the following qualifications: The applicant currently holds a certificate from the North American Board of Certified Energy Practitioners (NABCEP) in one of the following areas: PV Installation Professional or Solar Heating Installer Certification (solar hot water). The REP will then be able to install only the technology for which they hold a certificate. The applicant holds a current certification from United Illuminating (UL)s PV Installer Certification Program. This training is available to members of the International Brotherhood of Electrical Workers (IBEW) and the National Electrical Contractors Association (NECA). The applicant holds an Associates degree or higher in renewable or solar energy installation (or a related field) from an accredited school (e.g. New England Technical Institute, Rhode Island College, Community College of Rhode Island, etc.). The applicant holds a certificate of training from a manufacturer of a specific technology for the installation of that specific technology (e.g. solar roof shingles). The REP will then be able to install only the technology for which they hold a certificate. STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF LABOR AND TRAINING DIVISION OF WORKFORCE REGULATION AND SAFETY PROFESSIONAL REGULATION UNIT 1511 PONTIAC AVENUE BUILDING 70 P.O. BOX 20247 CRANSTON, RHODE ISLAND 02920-0943 (401)462-8580 FAX (401)462-8528 TDD (401)462-8006  HYPERLINK http://www.dlt.state.ri.us WWW.DLT.RI.GOV/PROFREGS *** APPLICATION FOR RENEWABLE ENERGY PROFESSIONAL CERTIFICATE AND SOLAR THERMAL PROFESSIONAL CERTIFICATE *** APPLICATION MUST BE CLEARLY PRINTED  - -  SOCIAL SECURITY NUMBER  LAST NAME FIRST NAME MI  STREET ADDRESS - CITY/TOWN STATE ZIP -- TELEPHONE -- DATE OF BIRTH  EMPLOYER  SELF-EMPLOYED/COMPANY NAME  STREET ADDRESS - CITY/TOWN STATE ZIP -- EMPLOYER TELEPHONE APPLICANTS MUST STATE WHAT LICENSE IS REQUESTED FOR OFFICE USE ONLY PLEASE DO NOT WRITE BELOW TEST FEE PAID, CHECK, CASH, M.O. DIVISION/COMMISSION APPROVAL FOR TEST $ __________________________________ ________________________________________________ COMMENTS ____________________________________ ________________________________________________ DATE PAID Applicant must answer all questions on both pages truthfully and swear to the same before a NOTARY PUBLIC, penalties for false information are as itemized in the General Laws of Rhode Island and Addendum. Statement may be investigated and verified for truthfulness. GENERAL LISTING OF WORK HISTORY NAME OF EMPLOYER FROM/TO TYPE OF WORK ____________________ __________________ __________________ ________________________ _____________________ _____________________ ________________________ _____________________ _____________________ EDUCATION List all education and schooling that you have received in the renewable Energy Professional and Solar Thermal Professional. LOCATION FROM/TO DEGREE/DIPLOMA ____________________ __________________ __________________ ________________________ _____________________ _____________________ ________________________ _____________________ _____________________ Listed employer or customer may be sent forms to attest to the truthfulness of all statements on this application and these will have to be sent back to this division, properly notarized, before any action is taken on this licensing application. _______________________________ __________________ ____________________________ APPLICANTS SIGNATURE DATE NOTARY SIGNATURE AND SEAL ELECTRICIAN COMPUTER CODETEST FEETWO YEAR LICENSE FEERenewable Energy ProfessionalREPC127NO TEST$ 240 PLUMBING  Solar Thermal ProfessionalSTPC056NO TEST$ 240       PAGE 2 R S    T _ d  ! = 񻰨񝕍wnbwwwbnhq}h w^5CJaJh x'5CJaJhq}h w^CJaJhq}hd CJaJhq}CJaJh x'CJaJhq}h2CJaJhCJaJhh4kLCJaJhdgCJaJhq}h `CJaJh `CJaJh4kLCJaJh~CJaJhq}h-CJaJhq}h4kLCJaJh05#&3T   N O 8^8gd x' & F ^gd x' & Fgd x' $Z]Za$gd x'gd w^ $]a$gddg$a$gd w^= J K   < n  6 a ~ ,Iz =KLl-.Kļ~x~x hRCJ h4kLCJ hdgCJ h_!CJhq}h_!CJaJhq}h4kLCJaJhq}hd CJaJhq}h `CJaJh `CJaJh w^CJaJh~_CJaJh x'CJaJhq}h w^CJaJh x'h w^5CJaJhq}h w^5CJaJ/ .Km|$a$gd w^8^8gd x' & F ^gd x'K*4;GHTr~ 3JWZ./!OQ~eop»»з~w~ h4kL5CJh4kL5>*CJh- hu4CJ h4kL5CJ h4kLCJ hO5 h_!5 hR5 hu45 h4kL5h4kL h~>*CJ he>*CJ hClS>*CJ h4kL>*CJ hR0Jjh4kLCJU h4kLCJjh4kLCJU h4kLCJ.Ff[$If$a$    Ffl$IfFf$IfWXYZ[]Ffl$If]^_`bcdefgFf;$Ifkd $$Ifl4ִ0    4 laf4$If &dPFf!$IfSTUVWXYZ[\]^_`Ff'$If`abcdeFf-$If !"#%&'(*+,-./01Ff:Ff2$If1q./  !-./OPQ~$a$#$d%d&d'dNOPQgdObcdeop/0rs   i9:;<$a$p/r 49:<GHIvw  ӿӿ處 h5 0J5jh5 0J5UhYjhYUhhF(eh_5 h_h_ h_hLOhLOhF(ehLO5hF(eh_5CJaJhF(ehLO5CJaJ h_5hdg h4kL5 h4kL5CJh_h{bh4kL-<IJXav$$&`#$/Ifa$gdF(e$&`#$/IfgdF(evwP@@--$$&`#$/Ifa$gdF(e$&`#$/IfgdF(ekd>$$Iflr E" g t 6`644 lap2ytF(e=--$&`#$/IfgdF(ekd>$$Iflr E" g t 6`644 lap2ytF(e$$&`#$/Ifa$gdF(e=-$&`#$/IfgdF(ekd}?$$Iflr E" g t 6`644 lap2ytF(e$$&`#$/Ifa$gdF(e$$&`#$/Ifa$gdF(e$&`#$/IfgdF(ePNNNNNNNkd-@$$Iflr E" g t 6`644 lap2ytF(e $a$     h4kL5hYh5 h5 5jh5 0J5U*hlM0J5mHnHu*2&P:pdg/ =!"#$% DyK www.dlt.state.ri.usyK 8http://www.dlt.state.ri.us/$$If!v h#v#v :V l055 40kd$$Ifl h*p2 x:0,,,,4 la$$If!v h#v#v#v#v#v#v#v#v #v #v #v #v #v :V l4 >1  0Z55555555 5 5 5 5 5 4f4p qZ kd$$Ifl4   & 4 C R `o~#2AP_ n! >1  0Zրրրր4 laf4p qZ$$If!vh#v #v:V l05 54kd{$$Ifld$ 2 @ N \ jx 0@@@@4 lay$$If!vh#v#v#v#v#v#v#v#v #v #v #v #v #v#v#v#v#v#v#v#v#v#v#v#v:V l ( 055555555 5 5 5 5 5555555555554pkd$$Ifl֘ & 4 C Q `o},;J ( 0xxxx4 lap$$If!v h#v#v#v#v#v#v#v#v #v #v #v :V l4055555555 5 5 5 4f4\kd1$$Ifl4   % 4 B 000004 laf4$$If!vh#v#v#v#v#v#v#v:V l4055555554f4$$If!v h#v #v :V l05 5 4Xkdk!$$Ifl $ 2 @ N \ jx .<JX f! 0րրրր4 la$$If!v h#v #v :V l05 5 4NkdK'$$Ifl $ 2 @ N \ jx .<JX f! 0րրրր4 la$$If!vh#v #v:V l05 54kd!-$$Ifld$ 2 @ N \ jx 0@@@@4 laE$$If!vh#v #v:V l ( 05 54pkd0$$Ifl֘$ 2 @ N \ jx .<J  ( 0xxxx4 lap5$$If!vh#v #v #v Y#v H:V l05 5 5 Y5 H4p֌ytRAkd9$$Ifl8$ 2 @ N  YH088884 lap֌ytR$$If!vh#v #v#vg#v:V l t 6`65 55g5p2ytF(e$$If!vh#v #v#vg#v:V l t 6`65 55g5p2ytF(e$$If!vh#v #v#vg#v:V l t 6`65 55g5p2ytF(e$$If!vh#v #v#vg#v:V l t 6`65 55g5p2ytF(es2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH 8`8 Normal_HmH sH tH BB  Heading 1$$@&a$5CJ>>  Heading 2$$@&a$>*>@>  Heading 3$$@&a$CJ>@>  Heading 4$$@&a$5T@T  Heading 5 $$d%d&d'd@&5CJD@D  Heading 6$$@&a$ 5>*CJ<@<  Heading 7$@&5CJ88  Heading 8$@&5DA`D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List 4>4 Title$a$5CJ2B2 Body TextCJ0U`0 Hyperlink>*B*."@. 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PLP^P`LhH. ]c-(`rUQ u;cTqU6n%$\L\m m<=p                             W        6                          32Y$5 H  d D -{b_!05#L& x'4G/S0u4KI7K4kLlMLOClSyT][ w^~_ `5`F(efAqJJ-O~2eq}4y\ dg_Rz@@UnknownG*Ax Times New Roman5Symbol3. *Cx Arial5..[`)Tahoma?= *Cx Courier New;WingdingsA$BCambria Math"1hs*Gs*G'GG 'G '!42QHP ?4kL2!xx 0STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONSLisa MandevilleCote, Ryan (DOA)<         Oh+'0 0< \ h t 4STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONSLisa MandevilleNormalCote, Ryan (DOA)2Microsoft Office Word@G@>c@< @< G՜.+,D՜.+,` hp  RI DLT'  1STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Title 8@ _PID_HLINKSAp chttp://www.dlt.state.ri.us/  !"#$%&'()*+-./0123456789:;<=>?@ABCDEFGHIJKLNOPQRSTUVWXYZ[\]^_`abcdefghijklmnoprstuvwxz{|}~Root Entry F)HData ,@1TableMsFWordDocument4VSummaryInformation(qDocumentSummaryInformation8yCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q