IGSHPA Continuing Education Credit Form
  IGSHPA certification is valid for three years. During those three years eight (8) points must me accumulated to renew the certification. The points can be accumulated in three ways – through employment, membership in an approved organization and/or education. Please complete the sections below as they apply to your accreditation renewal, then submit to IGSHPA.
  1. EMPLOYMENT    
  You may accumulate 4 points by remaining continually employed for three years in the combined geothermal heat pump and heating, ventilation, and air-conditioning field. For those with less than three years of employment, points are accumulated at the rate of 1.33 points per year.
 
  Employer Dates of Employment Years employed
 
  Employer’s Address Total Points (Number of years x 1.33):  
  2. MEMBERSHIP    
  You may accumulate points by continuous membership in IGSHPA, NGWA, ASHRAE, or similar organization. The points are accumulated 1 point per year of membership. Membership in more than one organization will apply toward accumulation of multiple points per year.
 
Dates of Membership # of years
  <--Provincial/State assoc. or other (use slider to indicate years)
 
Dates of Membership # of years
  <--Provincial/State assoc. or other (use slider to indicate years)
 
Dates of Membership # of years
  <--Provincial/State assoc. or other (use slider to indicate years)
      Total Points (Number of years x 1):  
  3. EDUCATION    
  You may accumulate points by participation in continuing education or professional activities in the combined geothermal heat pump and HVAC field. 2 points can be accumulated for each college credit hour. 2 points can also be accumulated for each 20 contact hours in seminars. Total contact hours times 0.1 = CEU credit points if less than 20 hours attended.
  Vocational or College Training     NOTE:  These are classes taken since your last renewal
   
  Course Name       School or University
   
  Instructor       Location    
  Certificate award?
 
        Dates Completed Number of Credit Hours Received
      Total Points (Credit Hours x 2):  
  EDUCATION (CONTINUED)          
  Conference Seminars/Sessions Attended
  NOTE: Seminars since your last renewal. If there are too many seminars to list, they may be combined.
 
  Seminar/Session Name Hours Date(s) Location
 
  Seminar/Session Name Hours Date(s) Location
 
  Seminar/Session Name Hours Date(s) Location
 
  Seminar/Session Name Hours Date(s) Location
 
  Seminar/Session Name Hours Date(s) Location
    Total Points (Contact Hours x 0.1):  
  TOTAL CEUs          
      Total CEUs:  
  CONTACT INFORMATION / ELECTRONIC SIGNATURE
 
  Name     E-mail     Date
  Signature
  By checking the box below I acknowledge that the information above is accurate to the best of my knowledge. I understand that submitting this information electronically is the equivalent of signing this form.
   
Acknowledgement of above statement      
  INSTRUCTIONS: Once the form is complete, click on the "Submit" button at the bottom to transfer form to IGSHPA. To return for payment, click on the link below or go to igshpa.org/certification-renewal.
  https://igshpa.org/certification-renewal/ <--Click here after form has been submitted