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Professional Qualification Standard for
Plumbing Fixture Replacement Technicians (PQ-100)

Apply to serve on the Consensus Committee.

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Part I: Gerneral Information

  1. Type of Application:


    1. Choose if this application is for an Organization (e.g., company, association, government agency, etc.), or for an individual member of the consensus committee.
    2. If this is an organizational application, choose if this application is for the Principal or an Alternate Representative for the organization.
    3. Select the Interest Category for this applicant. Applicants representing entities that can be classified in more than one Interest Group Category, one of which is a Producer Interest, are assigned to the Producer Interest Category. Individuals representing entities that can be classified in the General Interest and User Interest Categories are assigned to the User Interest Category.

    MembershipType:  
    Organizational Representative Type:  
    Interest Category:  
    General Interest (G):
    Represents Academia, Consumers, and Government Regulatory Agencies.

    Producer Interest (P):
    Represents a Distributor, Labor, Manufacturer, Material Association, Standards Promulgator, Testing Laboratory, and Utility.

    User Interest (U):
    Represents a Builder, Contractor, Applied Research Laboratory, Building Owner, Design Professional, Government Non-Regulatory, Insurance Company, Private Inspection Agency, and Product Certification/Evaluation Agency.

  2. Representative / Individual Applicant Information:


    Complete the following information on yourself (as the Representative or Individual Applicant). NOTE: If representing a different organization, the Organization Information (Question #3 below) must also be completed.

    Applicant Full Name:  
    Applicant Title:  
    Applicant Company:  
    Applicant Street Address:  
    Applicant City:  
    Applicant State:  
    Applicant Zip +4:  
    Applicant Phone:  
    Applicant Cell Phone:
    Applicant Fax:
    Applicant Email Address:
    Applicant Web Address:

  3. Organization Information:


    Complete the following information on the organization making this application.

    Write 'Same' in the 'Organization Name' field, if represented organization is the same as Applicant Company listed in Question 2.

    Organization Name:  
    Organization Main Contact Name:
    Organization Main Contact Title:
    Organization Street Address:
    Organization City:
    Organization State:
    Organization Zip +4:
    Organization Phone:
    Organization Fax:
    Organization Email Address:
    Organization Web Address: