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2019 NEBB TAB CT Application For Candidacy - v6 - 2019.08.01
2019 NEBB TAB CT Application For Candidacy - v6 - 2019.08.01
2019 NEBB TAB CT Application For Candidacy - v6 - 2019.08.01
Name:
(First) (Middle) (Last)
Street Address:
WORK
Street Address:
HOME
1) Applicants for the TAB CT certification must meet the education and experience pre-requisite
requirements in one of the categories listed in the chart below. Please indicate below the category
in which you qualify.
2) Copies of verification documentation must be sent with the completed Application for Candidacy to
validate the information entered in the Application. See explanation of verification information on
pg. 3.
University/College/School/GED:
CATEGORY A CATEGORY B
Associate Degree from an accredited community
college, trade school training or equivalent military High School Diploma or equivalent
training
AND AND
Minimum one-year field experience and completed Minimum two years’ field experience and a completed
alternative training course alternative training course
EMPLOYMENT HISTORY (Starting from Present Employer) Please attach additional pages if necessary
Job Title/Duties:
Employer:
Address:
Phone Number:
Job Title/Duties:
Employer:
Address:
Phone Number:
Job Title/Duties:
Employer:
Address:
Phone Number:
Place an X in the box to indicate which activity you participated in by employer. (For example, if you
participated in “HEPA Filter Testing” with the second employer in your list, you would put a check mark
under the # 2 column in line with the activity column.)
☐ ☐ ☐ ☐
☐ ☐ ☐ ☐
☐ ☐ ☐ ☐
☐ ☐ ☐ ☐
Individuals pursuing NEBB certification must indicate to NEBB that s/he has no notice, knowledge or
involvement of any litigation, government proceeding, or criminal investigation in progress, or having been
conducted in the past, relative to the Individual personally or said performed work.
Individuals must indicate if they have or have not been involved in any way in an investigation, lawsuit or
arbitration 1) issues of moral turpitude or 2) any work performed not in accordance with NEBB’s
Operational Standards and Procedures. ☐ No ☐ Yes
By signing this form, the Applicant attests that the above information is true and accurate and acknowledges
they have read and signed NEBB’s Arbitration Agreement and Code of Business Ethics (attached below) and
Candidate Handbook and agree to abide by NEBB’s governing documents. Failure to do so will disqualify the
Applicant.
Signature____________________________________________________Date______________________
The Certified Professional Applicant or Certified Technician Applicant (hereinafter called "Individual") shall read
and agree to the Arbitration Agreement stated below. This NEBB Arbitration Agreement applies to each NEBB
discipline certification held by the Individual.
The Individual agrees that if they fail to attain certification or, if certified, certification is subsequently suspended
or terminated, all claims, controversies or disputes of any kind whatsoever arising from such failure, suspension
or termination shall be resolved and settled by arbitration administered by the American Arbitration Association
under its Commercial Arbitration Rules, including its Rules for Emergency Measures of Protection (to the extent
that such Commercial and Emergency Rules are not amended or superseded by this provision).
The Individual furthers agrees that an interim or final order or judgement on any order or award rendered
pursuant to those Rules may be entered in any court having jurisdiction to do so (FOR THE PURPOSE OF
JURSIDICTION, THE INDIVIDUAL CONSENTS TO PERSONAL JURISDICTION AND VENUE IN THE UNITED STATES
DISTRICT COURT FOR THE DISTRICT OF MARYLAND OR THE CIRCUIT COURT FOR
MONTGOMERY COUNTY MARYLAND). The arbitration shall be conducted and decided by a single arbitrator. The
locale of the arbitration shall be in Washington, D.C. or its metropolitan area. Any judicial proceeding that the
Individual or NEBB institutes, in aid of arbitration or otherwise, shall be instituted in the United States District
Court for the District of Maryland or the Circuit Court for Montgomery County, Maryland.
The Individual further agrees that all claims, controversies or disputes shall be submitted to arbitration as provided
for herein no later than thirty (30) days after the Individual has been notified of said failure, suspension or
termination (which such notification shall be deemed to have been made as of the date on which it was delivered
to the individual by certified U.S. mail, email or facsimile transmission). If the Individual does not submit any claim,
controversy or dispute that this provision covers to arbitration within said thirty (30) days, the Individual hereby
acknowledges that they HAVE IRREVOCABLY WAIVED, ABANDONED, AND RELEASED ANY SUCH CLAIM, and
CONTROVERSY OR DISPUTE.
Preamble: Each NEBB Certified Individual shall not act in any manner that detracts from the reputation of
NEBB for certifying Individuals who provide quality service, in accordance with NEBB Standards, in a timely and
professional manner or in any other such manner that is, likewise, not in the best interest of NEBB.
The undersigned, by their signature below, acknowledge having read the foregoing NEBB Code of Business
Ethics, and NEBB Arbitration Agreement, acknowledge that they fully understand its content and agree to
follow the NEBB Operational Procedures.