Seminar Registration Form

Full Name*

First NameMiddle NameLast NameSuffix

Technical Associates Seminar Name*

Seminar Location*

Seminar Start Date*

MonthDayYear

Job Title*

Company*

Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Shipping Information

(For shipping your Certificate & your Seminar Material if you select the Pre-Ship option)

Where would you like your Certificate shipped (and Seminar Material if you select the Pre-ship option)?*

Shipping Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Is this a Residential or Business Address?*

Please ensure mailing address is correct to avoid additional shipping costs for returned mail.

Work Phone*

Area Code - Phone Number & ext.

Cell Phone Number

Area Code - Phone Number

Home Number

Area Code - Phone Number

Fax Number

Area Code - Fax Number

Business E-mail*

Personal E-mail

example@example.com

Type of Industry and Product Manufactured/Services Rendered by your Company:

Type of Instrumentation Used:*

Type of Software Used:*

ATTENDEES: Names, Titles, and Email Addresses of all Persons registering for the seminar. (NOTE: Provide names as they should appear on the Certificate).*

Please list any FOOD ALLERGIES of any ATTENDEES:*

Daily will provide breakfast, lunch, and a snack.

How will you be paying for the seminar?*

Is the student(s) registering for the OPTIONAL Exam:*

Names of all Persons registering for the optional EXAM.*

For the Asset Lubrication Technician Seminar, what exam do you wish to take?*

FORM F-05

Technical Assocaites Board of Certification (TABofC) Certification for Vibration Analysts conforms to the ISO 18436-2, Condition Monitoring and Diagnostics of Machines - Requirements for Training and Certification of Personnel Part 2: Vibration Condition Monitoring and Diagnostics. If you are requesting an examination date that is not previously scheduled, the location will be in Charlotte, NC.

If you are filling this out for multiple students, each student MUST fill out their own INDIVIDUAL Form-05. Please have each student use the following link to fill out their own form:

Candidate Application for Vibration Analyst Certification Form F-05

If you are filling this out for one student, please proceed with this form below.

Which units of measurement do you prefer on your exam?*

EnglishMetric

Technical Associates Board of Certification will consider any reasonable request for special needs accommodation on exam day to ensure fair, unbiased and impartial access for all candidates. Documentation of the disability and the need for special accommodations is required and must be submitted to TABofC for approval at least 30 days prior to the exam date.

Requested special needs accommodation:

Education: Two or more years of mechanical technology or engineering at an accredited college, university or technical school is recommended, but not required, for candidates seeking classification to Categories III & IV.

You will be required to show your photo ID to the exam proctor before taking the certification exam. This photo ID can be a driver's license, state issued ID, company ID or passport.

Training Hours for Full Certification: The total number of hours can be a combination of formal training, demonstrations, trainer-specified practical exercises and controlled self-study. Training hours for attending a vibration analysis ISO compliant seminar prior to the exam date may be included.

Category I:	30 hours
Category II:	38 hours over Category I
Category III:	38 hours over Category II
Category IV:	64 hours over Category III

Candidate agrees to supplement formal training with self-study of TABofC approved material if seminar duration is less than the total required hours.

If training was not provided by Technical Associates, please attach a copy of your ISO compliant Category I, II, III, or IV attendance certificate.

Experience for Full Certification:

Category I:	6 months
Category II:	18 months
Category III:	36 months
Category IV:	60 months

Work experience to date in the field of machinery vibration condition monitoring and diagnostics:*

Months

Previous Certification at Lower ISO Categories: You are eligible for full certification at Category III if you have valid ISO Category II certification and are eligible for full certification at Category IV if you have vaild ISO Category III certification.

What is your current ISO Vibration Analyst Certification Category (if more than one, select the highest)?*

Which ISO Vibration Analyst Certification Category are you now pursuing?*

If you are currently certified, what organization issued your Vibration Analyst Certification?

Technical AssociatesOther

Please email a copy of your certificate to JENNI RABASA, TABofC Certification Coordinator, if it was provided by a company other than Technical Associates.

*Candidates passing the exam but not having the required amount of training hours, vibration work experience and/or lower category certification, if applicable, will be classified as "Provisional Candidates" and issued a TAC certificate. It will be the responsibility of these candidates to notify TABofC in writing when they meet all of the criteria required for the ISO category. At that time, such candidates will be issued full ISO compliant certification at the pursued category.

By your signature below, you agree to comply with the certification requirements, adhere to the Code of Ethics and supply any information needed for this assessment. You also consent to TABofC releasing your test score to your company if requested. This form must be completed in full or your application for certification cannot be accepted and will be returned to you to be completed.

Print Your Name:*

Type your Full Name

Date*

Today's Date

Signature*

TABofC Form F-05 Version 2 08/06/19

P-05

Visit our ONLINE STORE to pay for the seminar and complete the payment process.

Do you want to be added to our mailing list to receive our email updates?*

Seminar Registration Form

VIBRATION ANALYST CERTIFICATION CRITERIA*