Operation Accreditation Reviewer Application

Operation Accreditation Reviewer Application
Applicant Information
Name*

First NameLast Name
Applicant Email
example@example.com
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country*
Please check the types of courses you have experience with:*

Low Elements- Facilitated (including portable)Dynamic Traversing Challenge Course- FacilitatedVertical Challenge Course- Dynamic-FacilitatedStatic Traversing Challenge Course- FacilitatedStatic Traversing Challenge Course- Self-GuidedVertical Challenge Course- Self-GuidedZip Tour/ Canopy Tour- Self-GuidedSwing Elements- GuidedFree-Fall Devices- GuidedZip Tour/ Canopy Tour- GuidedBridge Walks- Facilitated/Self-Guided/ GuidedOutdoor Climbing TowerIndoor Climbing WallsOther
Please List three (3) References that can validate your Industry expertise as marked from the above portion:
Reference 1
Name*

First NameLast Name
Company Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Reference 2
Name*

First NameLast Name
Company Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Reference 3
Name*

First NameLast Name
Company Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Please answer the following questions and upload supporting documents if requested.
I attest that I works for an organization that is insured to offer Operation Review services. I have include Proof of Insurance. **If your jurisdiction is outside of North America where requirements may be different, a letter stating the insurance requirements for your jurisdiction and proof that those requirements are met must be submitted.*

YesNo
Please Upload Certificate of Insurance

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I attest that I have experience providing external Operations Reviews as addressed in Chapter 2, Operation Standards, B.2.7. Of the 03-2019 ANSI/ACCT Standard*

YesNo
I attest that I have reviewed Section E of the Qualified Course Professional document for Qualified Operation Reviewer and understand the eligibility that is required to become an Operation Reviewer.*

YesNo
Qualified Course Professional- Reviewer
Your application must include a complete Portfolio that documents all required training and experience set forth by the ACCT for Operation Reviewers.*

YesNo
Please Upload Portfolio

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I hereby declare that the statements and responses to the questions in the Application are accurate and true and that I have not omitted, misrepresented, or misstated any facts. I understand and agree that the completion of the Application does not bind ACCT in any manner. Further, I understand that any misrepresentation or omission in this Application may void the agreement and give ACCT a right to terminate this agreement and terminate the Reviewer as an Approved Reviewer in the Program.
Signature*
Date*

MonthDayYear
Date
After you have completed this Application, please click submit. You will receive a payment link via email to complete your application purchase. You will receive a copy of this application; however, the application is NOT considered complete and will not be reviewed until payments are made.
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Operation Accreditation Reviewer Application

Applicant Information