Form Ccc Li 102A PDF Details

Preparing for the Landscape Irrigator Exam requires careful attention to registration details, a process streamlined by the CCC Li 102A form. Provided by the Infrastructure Training & Safety Institute, this form serves as the first step toward obtaining or renewing a landscape irrigation license, a necessity for professionals in the field. The form outlines options for first-time test takers and those needing retests, including specific sections on the principles of installation, backflow, hydraulics, and irrigation design. With a mandatory $111 license fee that covers one year and permits up to four exam attempts within this timeframe, candidates are urged to make each opportunity count. Additional requirements set forth include forwarding the completed form to the Texas Engineering Extension Service (TEEX), alongside necessary fees and documentation, at least 14 days prior to the desired exam date to secure a seat. Payment procedures are clearly specified, only accepting certified checks, money orders, or certain credit cards to streamline the process. Importantly, potential delays in processing due to incomplete or inaccurate application packets highlight the importance of precision when preparing registration documents. This form not only facilitates entry into the exam but also emphasizes the importance of responsibility and readiness on the part of each candidate, ensuring all involved parties—TEEX, the candidate, and the Texas Commission on Environmental Quality (TCEQ)—maintain high standards of professional qualification.

QuestionAnswer
Form NameForm Ccc Li 102A
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesCCC LI 102A_Irrigator_Regi stration_Form irrigation teex application form

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Landscape Irrigator Exam - Registration Form

 

 

Infrastructure Training & Safety Institute

 

 

800-SAFE-811 (800-723-3811) ● itsi@teexmail.tamu.edu ● www.teex.org/li

 

 

Mail to: TEEX-ITSI, 301 Tarrow, College Station, TX 77840-7896

 

 

 

 

I am registering for (check one):

 

If RETESTING for Landscape Irrigator:

Date exam was failed:________________

Landscape Irrigator Test

 

Principles of Installation

Location:__________________________

Landscape Irrigator Retest

 

Principles of Backflow

 

 

 

Principles of Hydraulics

# of times taken:____________________

 

 

Landscape Irrigation Design

 

 

 

The $111 license fee is valid for one year from date of first exam. You may retake the exam 3 times within that year if

 

 

necessary; however, you must pay $100 per exam. If you do not pass after 4 attempts or within 12-months from initial

 

 

exam, you must pay the $111 license fee again plus $100 exam fee, submit a new application and retake the exam.

_____________________________________________________________________

Participant Name: (Last, First MI)Social Security Number:

_____________________________________________________________________

Company/Agency:Email Address:

_____________________________________________________________________

Address:

_____________________________________________________________________

City:State:ZIP Code:

_____________________________________________________________________

Business Phone:Home Phone:Fax:

_________________________________

__________________________________

Facility and Date Requested for Exam:

Alternate Facility and Date Requested for Exam:

Registration Information

To register, please complete and return the required documents listed on page two of this packet to The Texas Engineering Extension Service. Be sure to include your TEEX exam fee, your TCEQ license fee and a copy of any applicable course certificates. Please see page two of this packet for additional details. Please do not fold or staple these documents.

The TEEX Customer Care Center must receive all registration documents and payment 14 days prior to the exam date. (No exceptions. Seating is limited.) Note: Registrations are taken into class dates on a first received, first entered basis.

Payment Information – Payment must accompany registration. Make check, cashier’s check or money order payable to Texas Engineering Extension Service (TEEX). The $211 fee for the Landscape Irrigator exam includes a $100 TEEX Exam fee and a $111 TCEQ licensing fee. Irrigator re-tests are subject to a $100 testing fee.

Arrange payment by one of the following methods:

1.

Certified Check* Enclosed payable to TEEX. (No personal or company checks.)

Amount: $__________________

2. Money Order #_______________________

3. Credit Card

MasterCard

Name on Card:

Visa

American Express

Discover

PIN-less Debit Card

Last 4 Digits of card number:

Signature: ____________________________________________

AD CODE: Y11RA1

ADMINISTRATION

 

 

 

ADMINISTRATION

CUT AND SHRED

FOR CUSTOMER SECURITY: REQUIRED INFORMATION BELOW WILL BE DESTROYED ONCE PAYMENT IS PROCESSED

CUT AND SHRED

Acct #:

 

 

Expires: _____________________

Individuals who submit incomplete application packets or inaccurate application information may be subject to processing

delays that prevent attending the requested exam date and location.

*By sending your check, please be aware that you are authorizing the Texas Engineering Extension Service (TEEX) to make a one-time electronic debit from your account at the financial institution on your check. This electronic debit will be for the amount of the check; no additional amount will be added to the amount and ALL transactions will remain secure. Please contact TEEX’s Financial Services Department at 979-458-6906 to learn about other payment options if you prefer NOT to have your check used in this way. We value your business and appreciate your selecting TEEX for your training needs.

CCC-LI-102A

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Revised 1/10/2011