ࡱ> WYV \bjbjNN D,w,w 4,,,h,4*-lP1t-(-------00000002f5t0-----0.-- 1...-p--0.-0..C/k/ϲ^,6.[//l 10P1c/5.5k/.k/---,, \:   Building Operator Certification Instructor Application BOC Courses (Check the courses for which you wish to be considered as an instructor.) BOC 101-Building Systems OverviewBOC 201-Preventive Maintenance & OperationsBOC 102-Energy Conservation TechniquesBOC 202-Advanced Electrical DiagnosticsBOC 103-HVAC and ControlsBOC 203-HVAC Troubleshooting & MaintenanceBOC 104-Efficient Lighting FundamentalsBOC 204-HVAC Controls & OptimizationBOC 105-Operation & Maintenance Practices for Sustainable BuildingsBOC 210-Advanced Indoor Air QualityBOC 106-Indoor Air QualityBOC 211-Motors in FacilitiesBOC 107-Facility Electrical SystemsOther Topics  HYPERLINK "http://www.theboc.info/training.html" http://www.theboc.info/training.html Personal Information Name: _________________________________________________________________ Organization: _________________________________________________________________ Address: _________________________________________________________________ City: _______________________ State _____ Zip: _____________ Phone: _______________________ Fax: _______________________ E-mail Address: _________________________________________________________________ Experience Instruction: Dates of Employment: __________________________________________________________ Employer: __________________________________________________________ Job Title: __________________________________________________________ Job Duties: __________________________________________________________ __________________________________________________________ Titles of Classes or Seminars Taught: _____________________________________________ __________________________________________________________ __________________________________________________________ Employer Contact and Phone Number: _____________________________________________ ___ Enclosed is an outline or syllabus for the classes referenced above (required). ___ Enclosed is a summary of student evaluations for the classes referenced above (optional). Industry: Dates of employment: Employer: ________________________ Job Title: ________________________ Job Duties: __________________________________________________________ Company Contact and Phone Number: ______________________________________ Instructor Application, continued (pg. 2 of 2) Dates of employment: Employer: ________________________ Job Title: ________________________ Job Duties: __________________________________________________________ Company Contact and Phone Number: _____________________________________________ ___ Enclosed is my resume (required). References Instruction (minimum of two) Name: ____________________________________ Organization: _____________________ ________________ Phone: ____________________________________ Email: ___________________________________________ Name: ____________________________________ Organization: _____________________ ________________ Phone: ____________________________________ Email: ___________________________________________ Industry Name: ____________________________________ Organization: _____________________ ________________ Phone: ____________________________________ Email: ___________________________________________ Professional Affiliations Association Name: ____________________________________ Member Status:_________________ Date of Membership: ______ Exp. Date:______ Association Name: ____________________________________ Member Status:_________________ Date of Membership: ______ Exp. Date:______ Education School, College or University: _____________________________________________ Dates Attended: __________________________ Degree(s)___________ School, College or University: ___________________________________ Dates Attended: __________________________ Degree(s)___________ Licenses or Certifications Licensing or Certifying Organization: _________________________________________ License(s) or Certificate(s):___________________________ Exp. Date: _________ Licensing or Certifying Organization: _________________________________________ License(s) or Certificate(s):___________________________ Exp. Date: _________ Signature I wish to be considered by NEEC as an instructor in the Building Operator Certification program. Signature: _________________________________ Date: ___________________________ Attachments (required): ___ Class/seminar outline or syllabus ___ Applicants resume Attachments (optional): ___ Student evaluations of recent class/seminar ___ Class/seminar handout materials Return to: Northwest Energy Efficiency Council, Attn: BOC Program 605 First Ave., Ste. 401 Seattle, WA 98104 EMAIL:  HYPERLINK "mailto:Cynthia@theBOC.info" Cynthia@theBOC.info     Northwest Energy Efficiency Council, 605 First Ave., Ste. 401, Seattle, WA 98104 v. 206-292-5592 f.206-292-4125  7BC  / 1 K L w y  2 4 O P m o ƼvhShc:CJOJQJjhc:CJOJQJUhc:CJOJQJhzhcCJhzhc:CJOJQJ hcCJhzhc6CJhNAJhc6CJ hc5CJhc5CJOJQJhc5:CJ,OJQJhNAJhc5CJOJQJaJ( 7 Xkd$$Ifl\n(F04 la$Ifgdc   / 0 1 K L w akd$$Ifl\n(F04 la$Ifw x y gaaaa$Ifkd|$$Ifl\n(F04 la  2 gaaaa$Ifkd:$$Ifl\n(F04 la2 3 4 O P m gaaaa$Ifkd$$Ifl\n(F04 lam n o gaaaa$Ifkd$$Ifl\n(F04 la     b q  > B J M ] f k ڼypypyh]hhEhc^JaJhc^JaJhc5CJ^Jh"hc5CJ^JhcCJOJQJ^Jh"hcCJOJQJ^J hzhchchShcCJaJ hcCJhShc:CJOJQJhZ>hc0J:CJOJQJjhc:CJOJQJU*jthZ>hc:CJOJQJU$   b gee`VH dh^gdc dhgdcgdc kd}$$Ifl\n(F04 la  C A Tp dh^gdc@ dh^@ `gdc dh^gdc dhgdcgdc P dh`gdc dhgdc dh`gdc   0 @ K M  yzAFpq!$.VXqr)XYxz#(Jrz|}ΡΒhEhcCJOJQJ^JhEhc6CJOJQJ^Jhc56CJOJQJh"hc6CJOJQJ^JhcCJOJQJ^Jh"hc5CJOJQJ^Jh"hcCJOJQJ^J hzhc9p$.L)XYnRU} h^^xgdc dh^gdcxgdc dh^gdc dh`gdcx^} ghi')2M] öçzsc\ hc5CJh 3hc5OJQJ^JaJ h 3hc#h 3hc5CJOJQJ^JaJhc5CJOJQJ^JaJhcCJOJQJ^JhEhcCJOJQJ^Jhc5CJOJQJaJh 3hc5CJOJQJaJhcOJQJhc5CJOJQJhEhc5CJOJQJhc5CJOJQJ#hi()2 C!"o45dgdcxgdcx^x^gdc^gdc^gdc^!"45PQ   ,=MORSklm *+b㷳ƣ㖣㣖vd"jhc5CJOJQJU^Jh 3hc5CJOJQJ^Jh 3hc5OJQJ^JaJhc5CJOJQJ^JhEhc5CJOJQJ^JhchEhcCJOJQJ^Jhc5OJQJ hc5h 3hcCJOJQJ^JhcCJOJQJ^Jh 3hc5CJOJQJ^J#5PQ@NOPQRSlm dh^gdc dh^gdc dhgdc +,c| $7XY[\ַhc5CJOJQJhNAJhc5CJOJQJhcjhcUh 3hc5CJOJQJ^Jhc5CJOJQJ^J#h@qhc0J5CJOJQJ^J"jhc5CJOJQJU^J.j;h@qhc5CJOJQJU^JYZ[\ $h]ha$gdch&d P ]hgdc$a$gdc&P:pc/ =!"#$%- 0P:pc/ =!"#$% P) 0P:pc/ =!"#$%$$If!vh55F55#v#vF#v#v:V l055F554$$If!vh55F55#v#vF#v#v:V l055F554$$If!vh55F55#v#vF#v#v:V l055F554$$If!vh55F55#v#vF#v#v:V l055F554$$If!vh55F55#v#vF#v#v:V l055F554$$If!vh55F55#v#vF#v#v:V l055F554 DyK %http://www.theboc.info/training.htmlyK Jhttp://www.theboc.info/training.html$$If!vh55F55#v#vF#v#v:V l055F554DyK Cynthia@theBOC.infoyK 6mailto:Cynthia@theBOC.info6666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH F`F NormalB*CJ_HmH phsH tH @@  Heading 1 $$a$B*CJN@N  Heading 2$x^`B*CJB@B  Heading 3$x^B*F@F  Heading 4$x^B*CJFF  Heading 5$x^B*CJFF  Heading 6$px^pB*CJB@B  Heading 7$P`B*B@B  Heading 8$x^B*J @J  Heading 9 $x5CJOJQJkHDA`D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List :P: Body Text 2 ^4>@4 Title$a$B*CJ8:J: Subtitle$a$B*CJ0>">  Footnote TextB*CJ@&1@ Footnote ReferenceH*4 @B4 Footer  !.)Q. 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Monthly Report TitleXH4L _PID_HLINKS_AdHocReviewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayName_ReviewingToolsShownOnce'A 7mailto:Cynthia@theBOC.infoP Y%http://www.theboc.info/training.htmlPaV}BOC Instructor Solicitationcynthia@putnamprice.comCynthia Putnam  !"$%&'()*,-./0123456789:;<=>?@ABCDEGHIJKLMOPQRSTUXRoot Entry FOӲ^ZData #1Table+5WordDocumentDSummaryInformation(FDocumentSummaryInformation8NCompObj` F Microsoft Word 97-2004 DocumentNB6WWord.Document.8