UA Certified Energy Auditor Certification Examination Form

UA Energy Auditor Course must be taught by a certified UA Energy Auditor Instructor.
The cost for the exam is $100.00 dollars per examination.
All fees must be prepaid and are NON REFUNDABLE.
A minimum of 10 applicants is required for an examination. If there are less than 10 applicants, a processing fee of $150.00 (computer based) will be applied
The request form and completed application(s) must be submitted no later than three (3) weeks prior to examination date. Please e-mail to ashley@nationalitc.com.
It is the requesting entity’s responsibility to notify each applicant

Please fill in the information below:
*Examination Location:

*Examination Address:

*City, State, Zip:

*Contact Person:

Phone No:

*E-mail Results To:

*Date of Examination:

Time:

*Number of Examinees:

Applicants NITC ID # / UA ID # (If Applicable):

Have all applicants completed 40 hours training course:

Do all applicant have:

GPRO Fundamentals & Mechanical:

STAR HVACR:

Or have all applicants completed an 80 hour training course:


Test packets will not be mailed to P.O. Boxes
Proctor’s Name:

Address:

City:

Phone:

Email: