Certification of

CONCRETE FIELD TECHNICIAN

GRADE I

The Concrete Field Technician Grade I exam is a nationally recognized test for all members of the Concrete Construction Community. Successful completion of both a written and performance examination entitles the applicant to certification by the American Concrete Institute as a Concrete Field Technician, Grade I. The San Diego International Chapter Sponsoring Group provides, for those pre-registered applicants, a three session training course. The course reviews concrete basics, test techniques, and provides the applicant with hands on training. Members of the San Diego International Chapter of the American Concrete Institute teach the course.

The three sessions will meet prior to test on:Wednesday6:00 P.M.–10:00 P.M.

Saturday6:00 A.M. – 1:00 P.M.

Wednesday6:00 P.M. – 10:00 PM

Test Day will be on:Saturday6:00 AM – 1:00 P.M.

Test times are pre-scheduled and late applicants may not be admitted.

To reserve your space return this registration form and payment to the San Diego Int’l Chapter Sponsoring Group.

Send payment to ACI, San Diego, P.O. Box 713110, Santee, California92072

For further information contact: Heather Caya (619/579-1940); fax (619/258-5839);

or e-mail

Please check our website aci-sandiego.org for your name as confirmation, under Certifications Tab, click on Field Grade I and below you will see schedule click on it, next click on the blue months that you have requested to view your name. Please allow 10 business days for us to update the website after you send in your application.

Certification of

CONCRETE FIELD TECHNICIAN

GRADE I

CostsPlease Circle Cost that Applies

Non-Member of ACI San Diego Chapter$425

Current Member of ACI San Diego Chapter$400

Retest Costs

Written Test only Must Show up to exam site by 6:00am on test day$125

Performance Test only $225

Rescheduling Fee$75

Cancellation Fee$75

***PLEASE NOTE ALL RESCHEDULES AND CANCELLATIONS MUST BE GIVEN ONE WEEK BEFORE THE START OF THE FIRST REVIEW SESSION! ANY TIME AFTER WILL BE AUTOMATIC FAILURE AND YOU WILL NEED TO PAY THE RETEST FEES! CANCELLATIONS DONE AFTER WILL BE LOSS IN PAYMENT!***

The cost is $425.00 for non San Diego International Chapter of American Concrete Institute members and $425.00 for current members. The cost includes only the test materials. Registered applicants that attend the three session training course will receive a course study book, and a one-year membership to the San Diego International Chapter of American Concrete Institute.

Please reserve ______spaces at $______each

See Website for Scheduling dates

First Choice Session______Concrete Technician Certification Course Grade I

Second Choice (in case first choice is full) Session______Concrete Technician Certification Course Grade I

NAMES:______

PHONE: FAX: ______

COMPANY:______POSITION: ______

ADDRESS:______

EMAIL ADDRESS REQUIRED:______

*PARTIAL REFUNDS ARE SUBJECT TO SPONSORING GROUP APPROVAL.

If the space reserved can not be filled by the registered applicant, a substitute may be admitted for the reserved dates only.

PAYMENT:

Check (payable to San Diego-International Chapter) ____ Visa ____ MasterCard ____ American Express

Card # ______Security Code ______Exp. Date ______

Billing Address of Credit Card ______City______State______Zip______

Signature ______

Return to ACI, San Diego, P.O. Box 713110, Santee, California92072