Proctor Application Form

Name *

First Name Last Name

Last 4 Digits of Social Security # *

MACS Certification # *

Company *

Email *

example@example.com

Phone Number *

Please enter a valid phone number.

Company Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Describe your qualifications to become a MACS Certification Trainer/Proctor (teaching experience, number of years in the automotive air conditioning industry, etc.... *

Signature *

I am applying to become a Trainer/Proctor for the Mobile Air Conditioning Society Technician Training and Certifi cation Program for Refrigerant Recovery and Recycling. I have reviewed the enclosed MACS National Trainer/Proc-tor Guidelines, and I agree to use MACS Technician Training and Certifi cation slide show, manual and test materials according to those guidelines. I further agree to conduct training and testing as required by MACS and as detailed in those guidelines. I understand that any misuse of these materials or complaints received by MACS regarding my implementation of the program will be investigated by MACS, with appropriate action to follow in the event that misuse is demonstrated. At no time while acting as a MACS Trainer/Proctor will I endorse any specifi c manufacturer of MVAC Service equipment or their products. I understand that any hands-on demonstration of the proper use of MVAC Service equipment in the course of train-ing will not include any compari-sons between products. While conducting training and testing with the MACS Technician Training and Certifi cation Program for Refrigerant Recovery and Re-cycling, I will only use UL listed and SAE certifi ed equipment.By signing this agreement, I agree to conduct the program as outlined by MACS, and agree to protect the integrity of the program by controlling distribution of the test to participants only, by not photo-copying and distributing the test to unauthorized persons and by taking any other measures neces-sary to see that the training/ testing program is administered within the guidelines MACS has provided. Clear

My Products *

Digital Download the presentation, trainer's certificate, tests and trainers manual

$ 65.00 Language

Printed Kit Consists of a download of the presentation, a printed Training Script, a trainer’s certificate, tests and training manuals. Includes a $10.00 shipping charge.

$ 125.00 Language

Additional Printed Materials (check to select options) In an effort to be more environmentally friendly we are recommending we recommend downloading the study manual whenever possible. Please mark how many of each you would like MACS to ship

Free

Printed Materials	Study Manual
Study Manual
Test

Total

$ 0.00

Payment Method

Credit Card
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Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Becoming a MACS Trainer/Proctor