Proctor Application Form

Name*

First NameLast Name

Last 4 Digits of Social Security #*

MACS Certification #*

Please check below if you have not been certified by the MACS Program in the last 5 years and require complementary mail-in certification materials sent to you at the address below.

Please send complementary test.

Company*

Email*

example@example.com

Phone Number*

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Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

I certify that I, or the company I represent, am/are member(s) of MACS in good standing.

YesNo, but I understand I must join before my materials will be mailed.

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 Certification 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 Certification 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 specific 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 training will not include any comparisons between products. While conducting training and testing with the MACS Technician Training and Certification Program for Refrigerant Recovery and Re-cycling, I will only use UL listed and SAE certified 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 necessary to see that the training/ testing program is administered within the guidelines MACS has provided.

My Products

DigitalDownload of the presentation and trainers manual. A hardcopy of the trainer's certificate and tests will be mailed.

$65.00 Language

Printed Training ScriptA printed training script in binder will be mailed to you in addition to everything included with the digital presentation purchase.

$60.00 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

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Becoming a MACS Trainer/Proctor