The following application must be completed and signed by December 31, 2022. Upon acceptance of the application, and appropriate fee, a 2023 NCT Certificate will be issued. NOTE: Please read all instructions carefully, failure to complete all sections correctly will result in a delay in the application processing and subsequently the charge of a $50 late fee.Section 1: Applicant InformaitonName First Middle Last Suffix Company Name Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone NumberEmail Section 2: QualifierAny individual who is unable to answer the following question in the affirmative must retake the NCT exam in order to renew certification. Have you been actively involved in the sale/service of air filters during the past year?Yes or NO* Yes No SECTION 3: Continuing Education RequirementsTo maintain NCT Certification, you must complete ONE continuing education credit per year from the categories listed below. This activity must have been completed between October 1, 2022 and September 30, 2023.Choose one:*Attended NAFA Technical SeminarAttended NAFA Annual MeetingAttend an industry recognized multi day technical seminar (ASHRAE, INDA or similar)Attend a 2+ hour training seminar related to HVAC/IAQ/Filtration given by a supplier/manufacturer of HVAC/IAQ/ Filtration related productsAttend 2+ hour seminar on HVAC, IAQ or filtration given by a related association or organization such as AABD, ACCA, AIA, AFE, AFS, AMIAQC, ASHE, ASHRAE, BOMA, CETA, EPA, IAQA, ICB, NAPE, NEBB, NEI, NSPE, RESE, SMACNA or TABBServe as Chair or Vice Chair of NAFA committee and attend at least 2 committee meetingsWrite a technical article for publication in Air Media or other recognized industry publication related to HVAC and air filtrationGive a technical presentation at the NAFA Tech Seminar, Annual Convention or other event related to HVAC/IAQ/Air filtration or otherwise present technical information related to the industry for educational purposesPresent an in-house seminar or attend an in-house seminar presented by a CAFS or other industry expert on a topic related to HVAC/IAQ/Air FiltrationPresent or attend a webinar presented by a CAFS or other industry expert on a topic related to HVAC/IAQ/Air FiltrationPlease describe below which activity you completed in order to satisfy the continuing education requirement for NCT renewal as specified. Please include the date and location for meeting attendance, or the name of publication and date your article was featured:* SECTION 4: NCT renewal feesBy signing this document, the Applicant affirms having completed sufficient credits (as listed above) to maintain the NCT certification. Further, Applicant agrees to keep proof of attendance at NAFA approved functions on file for at least one year from the date of this application and further agrees to allow NAFA, at anytime within that year, to request proof of attendance. Failure to provide proof of attendance will result in immediate suspension of all certifications.SECTION 5: Official SignaturesI have reviewed this application and attest that all information contained herein is correct and true. I understand that any misrepresentation is subject to disciplinary action by the NAFA Board of Directors including but not limited to revocation of certification and/or termination of membership.SignatureName* First Last By entering your name, email and company name, you are signing this document.