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ICC Instructor Candidate Application

After completing application, click the "submit" button at the bottom of this application.

Required fields

First Name:

Middle Initial:

Last Name:

E-mail:

Application confirmation will be sent to this e-mail.

Are you a
member of ICC?

YES NO

ICC Member Number:

HOME INFORMATION

Address:

(No P.O. box, please)

City:

State/Province:

ZIP:

ZIP +4:

Country:

Non-U.S. and Non-Canadian, please disregard State/Province and ZIP fields

Phone:

(xxx-xxx-xxxx)

Mobile Phone:

(xxx-xxx-xxxx)

Fax:

(xxx-xxx-xxxx)

E-mail:

WORK INFORMATION

Jurisdiction/Company:

Title:

Address:

(No P.O. box, please)

City:

State/Province:

ZIP:

ZIP +4:

Country:

Non-U.S. and Non-Canadian, please disregard State/Province and ZIP fields

Phone:

(xxx-xxx-xxxx)

Mobile Phone:

(xxx-xxx-xxxx)

Fax:

(xxx-xxx-xxxx)

E-mail:

Send all correspondence and materials to:

Home Address Work Address

I can be reached during the day:

Home Phone	Home Mobile
Work Phone	Work Mobile

EDUCATION

Certificate in:
Associate's degree in:
Bachelor's degree in:
Master's degree in:
Other, please indicate:

PROFESSIONAL CREDENTIALS

Licenses/Registrations:
PE	FPE	SE	Architect

Certifications:
ICC MCP	ICC CFM	ICC CBO
Other, please list:

BACKGROUND AND EXPERIENCE

Have you attended a Train-the-Trainer or similar type of course?		YES NO
	*If yes, please indicate where and when:*

Have you participated in developing training or course materials?		YES NO
	*If yes, please indicate what and when:*

Are you interested in serving as a subject matter expert or technical reviewer on an ICC curriculum development team?		YES NO

Have you ever served on a certification examination committee?		YES NO
	*If yes, please indicate when and where:*

Are you able to work with tight deadlines while maintaining quality and accuracy?		YES NO

Please select what best describes your TRAINING/TEACHING experience:
Less than 1 year	1-5 years	6-10 years
More than 10 years	None

Please select what best describes your experience in CODE ENFORCEMENT:
Less than 1 year	1-5 years	6-10 years
More than 10 years	None

Please select what best describes your experience in CONSTRUCTION/BUILDING:
Less than 1 year	1-5 years	6-10 years
More than 10 years	None

Please indicate qualities and skills you possess that make you an excellent candidate to teach ICC seminars? Briefly list:

Area(s) of expertise: (check all that apply)
International Building Code International Residential Code International Fire Code International Existing Building Code International Plumbing Code International Mechanical Code International Fuel Gas Code International Property Maint. Code	International Energy Conservation Code International Zonnig Code International Private Sewage Disposal Code International Wildland-Urban Interface Code ICC Performance Code for Buildings and Facilities International Code Council Electrical Code Administrative Provisions Administrative/Non-Technical
Other, please indicate:

List seminars that you are specificially interested in teaching:
(For a complete list of ICC seminars, click here.)

If there are any DAYS of the week or MONTHS of the year you CANNOT travel/teach, please list:

Please provide three (3) professional references that ICC may contact:
(Please include contact information for each reference you provide)

       ICC Staff or Board of Director:


       ICC Chapter Official:


       State level official:


Please insert your resume information below:
copy/paste text - no formatting


Click submit to process. Please wait.

If you need assistance or have any questions,
please contact
1-888-ICC-SAFE (422-7233), ext. 7532.

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