CET Renewal Form

ETA

 
Print this form and mail to: 	ETA International
                             		5 Depot Street
                             		Greencastle, IN 46135
 
 
Your CET #:_______________________  Date Certified:____________________
 
By Which Organization?
 
ETA( ), NEA ( ), NICET ( ) ISCET, Other ( ) ________________________________
                                                                                   (name of other organization)
Your name:_________________________________
 
Current Address: __________________________________
 
City:_________________________ St:_____ Zip:______________
 
Your age now: ______ (In what state were you originally certified)? _______
 
Phone # (____) ______-___________ Best time to call ___________________

E-mail address __________________________________
 
( ) My certification is less than 4 years old. I am reporting my CET #
    and current address at this time for information update only.

( ) My CET is older than 4 years, I plan to recertify.
    I need the following: 
    ___________________________________________________________________
    ___________________________________________________________________

( ) I would like to order the following study materials, computer disks, practice exams 
     and/or study guides _____________________.

( ) I am submitting data on studies completed during the past ______years.
    Please let me know if this counts towards my recertification.

( ) I am an Associate CET, certified (date) ____________. I am submitting
    proof of 20 hours continuing education to keep my Associate CET valid.
      
Note: Associate CET is valid for only two (2) years. 
 
 
All renewals are half the current test fee,  except CNST and CWS/T which is $100 and FOI which is $150. 
   
Exam Cost Renewal Cost
CNCT/CST - $75 CNCT/CST - $37.50
CET/Journeyman - $75 CET/Journeyman - $37.50
CETsr - $100 CETsr - $75
CNST and CWS/T - $100 CNST and CWS/T - $100.00
 
 
( ) Check  or  ( ) Charge # _______________________________ CID #_________ Exp Date ____/____
 
Please sign here X ____________________________________