SEEC_CBA_TL_1801 AEE International Application Spreadsheet- NEW EXAM

Certification
Certification Type: Exam Date: Administrator:

Instructor(s) Name: Course Date: Email:

Country, City: Date Submitted to AEE: Address:

Phone:
*possible examples below
Employer, Dates
Given Company Street Preferred Contact College/Univ Attended Employeed (Month &
N Gender Prefix Name Family Name Nationality Company Name Position Title Address Company City Company State/Province Company Country Company Postal Code Company Phone # Company Fax # Company email address Home Street Address Home City Home State/Province Home Country Home Postal Code Home Phone # Personal Email Office or Home and Number of Years Type of Degree received/Field of Degree Year) , Description of Total # Years of Experience
Work Performed & job
duties

Bechtel (January 1967-

1977)- performed
energy management
activities such
conducting energy
1) (4 years) 1968-1972: audits and measuring
Association of 3168 Mercer University of New York 1) Bachelor of Sciences/Mechancial and verifiying savings
1 Male Mr. Albert Thumann American Energy Executive Director University Drive Atlanta Georgia USA 30341 770-447-5083 770-446-3969 Al@aeecenter.org 777 Main Street Atlanta Georgia USA 77777 777-777-7777 al@aeecenter.org Office 2) (3 years) 1973-1975: Engineering 2)Masters Degree/Electrical of new equipment 46
Engineers Engineering installed. Association
University of New York of Energy Engineers
(January 1977-January
2013)- Founder and
Executive Director, in
charge of all operations
of AEE

1
2
3
4
5
6
7
8
9
* The Local Certification Board certifies the information provided for the applicant has been verified and is deemed to be correct to be best of my knowledge. By indicating the applicant is "Approved" I certify that the individual
meets the requirements for certification including; at least 3 years of field related work experience and a passing score on the certification exam. The individuals that are "NOT APPROVED" did not receive a passing score
on the exam and will therefore not be certified.

Authorized Signature

** In this field please indicate the Certification Type the board has approved each applicant for. If an individual receives a passing score on the exam, but does not have the minimum 3 year experience
requirement they can be approved for an in-training certification [not applicable for all certifications]. Once the applicant has 3 years of experience in a related field they may then resubmit an application within a specified time frame
without retaking the exam.

Saudi Aramco: Company General Use

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Saudi Aramco: Company General Use

 Version

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Saudi Aramco: Company General Use