Application for Collection Systems Operation Certification - Indiana WEA

Applications for the Spring 2024 test dates are currently CLOSED. Please only apply if you are interested in the Fall or testing through PSI. If you have any concerns, please reach out to staff@indianawea.org.

Select the level of Certification Exam you are applying for:(Required)

CS-I

CS-II

CS-III

CS-IV

Name(Required)

First Last

Email(Required)

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you plan to take the exam in the Spring or Fall?(Required)

Spring

Fall

I will be taking the test through PSI and understand this is a higher fee.

What date will you take the exam?(Required)

Visit https://indianawea.org/collections-exams-portal-2/ for a list of exam dates hosted by IWEA. Otherwise, you will need to take the exam with PSI.

Which location will you take the exam?(Required)

Visit https://indianawea.org/collections-exams-portal-2/ for a list of locations and exam dates hosted by IWEA. Otherwise, you will need to take the exam with PSI.

Have you previously applied for a Collection Systems Certificate?(Required)

Yes

What certifications do you presently hold?(Required)

Water Treatment

Water Distribution

Municipal Wastewater Treatment

Industrial Wastewater Treatment

Wastewater Collection Systems

Other

None

Please input your Water Treatment Certification Number, State and Grade (Class)

Please input your Water Distribution Certification Number, State and Grade (Class)

Please input your Municipal Wastewater Treatment Certification Number, State and Grade (Class)

Please input your Industrial Wastewater Treatment Certification Number, State and Grade (Class)

Please input your Wastewater Collection System Certification Date, State and Grade (Class)

If you chose "other" please input the Name, Certification Number, State and Grade (Class)

Education History

Name of High School(Required)

Number of Years Attended(Required)

Location of Your High School (City, State)(Required)

Name of College Attended

Number of Years Attended

Location of Your College (City, State)

Please upload verification of your post-high school qualifications.

Copies of college transcripts or certificates of completion for courses related to wastewater treatment/collection provide acceptable proof of educational qualifications. You may list training courses, short courses, or other courses in the wastewater field that you have attended. Include only post-high school information.

Max. file size: 50 MB.

If you have any additional verification of your post-high school qualifications, please upload below.

Max. file size: 50 MB.

Work History

Below you will list your present employment first then any additional employment. Give a detailed description of your collection system work experience, as designated below. If you are not a full-time Collection Systems Operator, specify the average number of hours per week that are spent in the actual operation and maintenance of the collection system. NOTE: If you are applying for a Class III or IV examination, clearly define AND document your "in-charge" experience and qualifications (supervision does not necessarily dictate "in-charge" experience).

Current Employer(Required)

Dates From:(Required)

Dates to present:(Required)

Job Title(Required)

Number of Persons Supervised(Required)

Job Description(Required)

Collection Systems Duties(Required)

Classification of Wastewater Treatment Plant (You can Select More than One)(Required)

Wastewater Treatment Plant Capacity(Required)

Gallons per Day (gpd)

Supervisor's Name(Required)

First Last

Supervisor's Email(Required)

Supervisor's Phone(Required)

Do you have prior employment to add?(Required)

Yes

Would you like to input below or attached a resume?(Required)

Input below

Attach a Resume

Please attach your Resume

Max. file size: 50 MB.

Prior Employment

Previous Employer 1

Date From

Date To

Job Title

Number of Persons Supervised

Job Description

Collection Systems Duties

Classification of Wastewater Treatment Plant (You can Select More than One)

Wastewater Treatment Plant Capacity

Gallons per Day (gpd)

Supervisor's Name

First Last

Your supervisor will be emailed a seperate form to verify your employment status. Please ensure this is completed as your application will not be valid without it.

Supervisor's Email

Supervisor's Phone

Previous Employer 2

Date From

Date To

Job Title

Number of Persons Supervised

Job Description

Collection Systems Duties

Classification of Wastewater Treatment Plant (You can Select More than One)

Capacity of Wastewater Treatment Plant

Gallons per Day (gpd)

Supervisor's Name

First Last

Supervisor's Email

Supervisor's Phone

Additional Education/Courses

Do you have additional educational course information you would like to add?(Required)

Yes

Courses require attachment of completion verification and/or transcripts

Name of Course

Location of Course

Start Date of Course

End Date of Course

Educational Units or Class Hours

Upload Course Verification and/or Transcripts

Max. file size: 50 MB.

Do you have a 2nd educational course you would like to add?

Yes

Name of Course

Location of Course

Start Date of Course

End Date of Course

Educational Units or Class Hours

Upload Course Verification and/or Transcripts

Max. file size: 50 MB.

Do you have a 3rd educational course you would like to add?

Yes

Name of Course

Location of Course

Start Date of Course

End Date of Course

Educational Units or Class Hours

Upload Course Verification and/or Transcripts

Max. file size: 50 MB.

Do you have a 4th educational course you would like to add?

Yes

Name of Course

Location of Course

Start Date of Course

End Date of Course

Educational Units or Class Hours

Upload Course Verification and/or Transcripts

Max. file size: 50 MB.

Applicant Acknowledgement

Applicant Acknowledgment(Required)

I certify that I am the above applicant; that all statements made and information contained in this application are true to the best of my knowledge and belief; that I understand that any omissions or misrepresentations may result in ineligibility for the examination applied for. I also consent to a thorough investigation of my employment record and other qualifications in related activities for the purpose of verification of my qualifications for the certificate for which I have applied.

Non-refundable Deposit

Please note there is a non-refundable deposit for this exam application.

Are you an IWEA Member?(Required)

Yes

Please select your class:

There is a non-refundable deposit for this exam.

Class I-$70

Class II-$70

Class III -$80

Class IV -$80

Please select your class:

There is a non-refundable deposit for this exam.

Class I-$130

Class II-$130

Class III -$140

Class IV -$140

Total

Payment Type(Required)

Credit Card

Check (Payable to IWEA)

Check with Purchase Order

Purchase Order

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Education History

Work History

Prior Employment

Additional Education/Courses

Applicant Acknowledgement

Non-refundable Deposit

Join IWEA

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