CDSEC Webinar Application CDSEC Examination Application Read the instructions and eligibility requirements before you complete this application. "*" indicates required fields Step 1 of 7 14% General InformationName* First Middle Last Company or AgencyMailing Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Office PhoneFax PhoneHome or Cell PhoneEmail Address* Background InformationYou must answer each question in this section before we can process your application.During the last 10 years, were you fired from any job for any reason, did you quit after being told that you would be fired, or did you leave by mutual agreement because of specific problems?* Yes No Have you ever been convicted of any felony violation?* Yes No Are you now under charges for any violation of law? Do not include traffic violations.* Yes No Have you ever been denied a technical certification or license?* Yes No Have you ever had a technical certification or license revoked or suspended?* Yes No Background Information Explanation*Explain why you answered YES in the above section. Educational ExperienceList below any Educational Experience that you are requesting Ecopliant Environmental, Inc. to consider towards the minimum seven (7) years required experience in stormwater pollution prevention and/or sediment and erosion control design and/or review work. Please refer to the Prerequisites and Qualifications page for maximum time allocated for education experience. Include any official transcripts as attachments to this application.Educational Experiences Training Organization/Sponsor and Location Training Hours Actions Edit Delete There are no Educational Experiences. Add Educational Experience Maximum number of educational experiences reached. Related Certifications(Optional) List any current Professional Licenses.Certifications Certification Expiration Date Actions Edit Delete There are no Certifications. Add Certification Maximum number of certifications reached. Design and Construction Experience ProfileApplicants must demonstrate AT LEAST SEVEN YEARS of sediment and erosion control and/or stormwater pollution prevention design and/or review experience. Please refer to the Prerequisites and Qualifications page for how this experience can be accepted. Include additional pages if required. If your work and/or experience is deficient in meeting either criterion, but you have similar skills that you feel should be considered, submit a written request to the Board of Directors at administrator@ecopliant.org for an assessment of your qualifications.Employers Company/Agency/State/City/County Name Phone What position(s) did you hold? Actions Edit Delete There are no Employers. Add Employer Maximum number of employers reached. Additional InformationAdditional Sediment and Erosion Control or Related ExperiencesList any sediment and erosion control and/or stormwater pollution prevention design and/or review related experience that was not covered in the above section. ReferencesThree completed reference forms must be submitted with this application. At least one reference must be from someone who is not a co-worker. Reviewers may send their completed reference forms directly to Ecopliant Environmental, Inc. by mail, email, or fax. Written approval from Ecopliant Environmental, Inc. is required before an applicant may sit for the examination. Providing false or misleading information on any part of this application may result in denial or revocation of CDSEC certification.References Name May we contact this person? Actions Edit Delete There are no References. Add Reference Maximum number of references reached. Consent* I agree to the termsBy checking this box, I acknowledge and agree to the following: I understand that any information I provide may be verified by Ecopliant Environmental, Inc. I consent to the release of information about my skills, abilities, professional ethics, and work history by current and former employers, schools, and references. I have read and agree to fully abide by the following CDSEC Code of Ethics. CODE OF ETHICS Certified Designer of Sediment and Erosion Control Article I. General Principles 1. The privilege of professional practice imposes obligations of morality and responsibility as well as professional knowledge. 2. Each Certified Designer of Sediment and Erosion Control (hereafter called CDSEC) agrees to be guided by the highest standards of ethics, personal honor, and professional conduct. Article II. Relation of Professional to the Public 1. A CDSEC shall not give a professional opinion or make a recommendation without being as thoroughly informed as might reasonably be expected of a similarly situated professional. 2. A CDSEC shall not knowingly permit the use of his or her reports or other documents for any unsound or illegitimate undertaking. 3. A CDSEC shall not issue a false statement or false information at any time. 4. A CDSEC shall not make any sensational, exaggerated, and/or unwarranted statements in any professional opinion or in the course of performing any professional services. 5. A CDSEC may publish dignified business, professional, or announcement cards, but shall not advertise his or her work or accomplishments in a self-laudatory, exaggerated, or unduly conspicuous manner. Article III. Relation of Professional to Employer and Client 1. A CDSEC shall not use, directly or indirectly, any employer or client’s information in any way that would violate the confidence of the employer or client. 2. A CDSEC shall protect, to the fullest extent possible, the interest of their employer or client insofar as such interest is consistent with the law and his or her professional obligations and ethics. 3. A CDSEC who finds that his or her obligations to their employer or client conflict with his or her professional obligation or ethics should address such objectionable conditions or resign. 4. A CDSEC who has performed an investigation for any employer or client shall not seek to profit economically from the information gained. 5. A CDSEC shall not divulge any information given in confidence. 6. A CDSEC shall engage, or advise his employer or client to engage, and cooperate with other industry specialists whenever the employer or client’s interests would be best served by such service. Article IV. Relation of Professionals to Each Other 1. A CDSEC shall not falsely or maliciously attempt to damage the reputation of another. 2. A CDSEC shall refrain from plagiarism in oral and written communications. 3. A CDSEC shall endeavor to cooperate with others in the profession and encourage the ethical dissemination of technical knowledge. Article V. Duty to the Profession 1. A CDSEC shall uphold this Code of Ethics by example and encourage other CDSECs to do the same. Article VI. Conflicts of Interest 1. A CDSEC shall not, without specific inspection experience, perform stormwater inspections. 2. A CDSEC shall not receive compensation for design work from more than one party unless agreed to by the client(s). 3. A CDSEC shall not accept compensation, directly or indirectly, for recommending contractors, services, or products to clients or other parties having an interest in projects. I certify that all information submitted in this application is accurate and true to the best of my knowledge and that all information regarding this application will remain confidential. I understand that Ecopliant Environmental, Inc. must receive all application materials, three reference forms, and a completed administrative form at least 21 days prior to the scheduled in-person examination date.