(You may complete the application below or Download The Application and email it back to us.)
All fields with an asterisk (*) must be completed for registration.
Full Legal Name As Shown On ID *FIRST: MIDDLE: *LAST: SUFFIX: CCO NUMBER: *DATE OF BIRTH: *PERSONAL MAILING ADDRESS: *City: *State: *Zip:
*PERSONAL EMAIL ADDRESS: (unique to candidate) *CELL PHONE: HOME PHONE: *DATE OF COURSE/EXAM(S) YOU PLAN TO ATTEND: T-SHIRT SIZE: COMPANY/ORGINIZATION: COMPANY PHONE: REFERRED BY:
Note: NOTE: This application is for recertification only. You may only recertify for the designation(s) in which you are currently certified. You may mark additional exam(s) you would like to add to your certification. MARK the crane type(s) for which you are applying.
WRITTEN EXAMS: Mobile Core ExamLattice Boom Crawler (LBC)Lattice Boom Truck (LBT)Telescopic Boom Swing Cab (TLL)Telescopic Boom Fixed Cab (TSS)Tower CraneArticulating Boom CraneDigger DerrickRigger 1Signalperson
ADDITIONAL EXAMS: Lattice Boom CraneTelescopic Boom Swing Cab (TLL)Telescopic Boom Fixed Cab (TSS)Tower CraneArticulating Boom CraneDigger DerrickRigger 1Signalperson
Do you have 1,000 hours of documented crane-related experience during your current certification period? ---Yes, and I understand that NCCCO™ may, at any time, request documentation to be provided in order to verify my experience, and if such documentation is not provided my certification may be impacted.No, and I understand I must take and pass the practical exam(s) prior to my expiration date.
Applications for paper/pencil written exams are due two weeks before testing date. Late applications will be accepted with $50 late fee up to 5 business days prior to testing date. I am confirming that the information given in this application is complete to the best of my knowledge. I understand that initial scheduling deposit is non-refundable and will be used as credit toward my total balance. Any changes to exams after registration may result in additional fees owed.
*CANDIDATE SIGNATURE: *DATE:
