Medical Gas Installer/Brazer Certification Examination

TO QUALIFY FOR THIS EXAMINATION all candidates must meet the requirements of the ASSE Series 6000, Professional Qualifications Standard for Medical Gas Systems Personnel, Standard 6010.

Applicants should include the following:
1. Successful completion of a minimum 32-hour training course conducted by an instructor certified to ASSE 6050 and
2. Successful completion of a written and a practical examination covering all facets of ASSE Standard 6010, NFPA 99, and NFPA 55 and
3. A minimum of four years of documented practical experience in the installation of piping systems.

General
Personal Info
Experience
Agreements

I will be taking this exam at the instruction site upon completion of my course.

I will be taking this exam at a PSI center. (Provide method of payment below.)

I have a minimum of four (4) years of documented practical experience in the installation of piping systems.

I will have completed the required 32-hour training course prior to my test date. (Course instruction must be conducted by a Medical Gas Systems Instructor certified to ASSE 6050. See ASSE Standard 6010.)

I have read the Candidate Information Bulletin for NITC Medical Gas Installer/Brazer Examination.

I am requesting the examination to the NFPA 99-2018 Edition.

I would like to receive notifications via text.

I would like to receive notifications via email.

First Name*

Last Name*

SSN #

Address Line 1*

Address Line 2

City*

State*

Zip Code*

Email*

Home Phone

Work Phone*

Training Course Location*

Training Course Date*

Name of Instructor*

Local Union #

NITC ID # / UZ ID #

List your present or most recent employer first. Attach any documentation you have that would prove that you have four (4) years experience in the installation of piping systems. Acceptable documentation: letters from employers, employment history, certification records, state license(s) and any other employment records. (Phone numbers are required for verification.)

Employer Name*

City*

Phone*

Email

From*

To*

add employer

I do solemnly swear or affirm that the above statements are true. I further realize that falsification of these statements shall be cause for disqualification.

As a holder of a NITC Certification I shall agree to the following:

  • I will make no false claims about the scope of my certification(s)
  • I will not engage in false or misleading advertising of my NITC Certification, nor shall I utilize an NITC certification in any manner that portrays NITC unfavorably.
  • I will not utilize any written documents, reports, procedures, etc., with the NITC certification mark in any manner whatsoever that may be inaccurate or false.
  • I will notify NITC without delay of any changes in my capability to fulfill the requirements of this certification.

I understand that NITC reserves the right to suspend or revoke my certification should I violate these obligations. Should my certification be revoked, I agree to cease and desist any and all references to being the “holder” of an NITC Certification and shall return any certificates, including wallet sized photo identification cards to NITC.

I understand and agree that my examination results may be shared with the course instructor, training coordinator or training entity. By affixing my signature to this application, I agree to abide by the rules and regulations of certification holders as set forth by the NITC Certification Committee.