Certified Water-Based Systems Professional (CWBSP) Program Application
NFPA Certification Department For Internal Use Only
1 Batterymarch Park, Quincy, MA 02169 Date Received: ___________________
(P) 1-617-984-7495 Database: ______________________
Email:
[email protected] Payment Rcvd: ___________________
Web Page: www.nfpa.org/cwbsp
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FOLLOWING LINK: https://www.nfpa.org/cwbspapply
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APPLICANT NAME: ___________________________________________________________________________________
(As name will be printed on certificate)
BUSINESS INFORMATION:
Business Name: __________________________________________________ E-mail:_____________________________
Business Mailing Address: _____________________________________________________________________________
City: __________________________ State: _____________ Country: ___________________ Zip Code: ______________
Business Phone: _________________ Mobile Phone: ___________________
Work Field / Job Description: Please check the most appropriate box or boxes.
Engineer, PE Design Engineer Fire Protection Engineering
Layout Technician . Design Manager Water-Based Systems Designer
Job Title (if other than above)____________________________________________________________________________
HOME INFORMATION:
Home Mailing Address: ______________________________________________Home E-mail: _____________________
City: _________________________ State: _____________ Country: ___________________ Zip Code: ______________
Home Phone: _________________ Mobile Phone: _______________
Note: The CWBSP exam is available on demand as a computer-based test at assessment centers throughout the world. Upon
receipt of this CWBSP program application. documentation and your test fee, the NFPA will e-mail your authorization letter
with instructions on how to schedule the computer-based exam. A list of computer-based test centers is located at the test
administrator’s website at www.isoqualitytesting.com.
Please attest to one of the following:
I have attained the minimum of a high school diploma or equivalent education and have five years of verifiable work
experience related water-based systems. COPY OF RESUME REQUIRED
I have attained a Bachelor's degree in engineering, technology, or other related discipline from an accredited college or
university and have four years of verifiable work experience related water-based systems. COPY OF DIPLOMA AND
RESUME REQUIRED
I, __________________________________, certify that all information contained in this application, is accurate and truthful,
to the best of my knowledge, and that I am aware that any false entry will be considered sufficient cause for revocation of my
certification at any time during the certification term. I agree to be bound by and to adhere to all written policies and
procedures of the certification program to which I am herewith applying, and I understand that at any time during the term of
certification any improper conduct on my behalf will result in my certification being revoked. I understand that the certification
examination that I will take as prerequisite to certification is confidential and is protected by federal copyright and other
intellectual property and trade secret laws. I understand and agree that I will strictly preserve the confidentiality of the
examination and that I am prohibited from copying or distributing the examination or from transmitting information regarding
examination questions or content in any form, written or oral, to any person or entity. I further understand that my failure to
comply with this prohibition may result in my certification being permanently revoked and/or legal action being taken against
me. I agree to accept the decision of the NFPA as to my eligibility for certification. I authorize verification of all information in
this application. I also hereby release the NFPA and all of its agents, employees, officers, directors, heirs, and assigns from
any liability arising whatsoever from or in connection with any action taken or decision made with regard to the awarding,
suspension or revocation of my certification. I acknowledge and agree that the NFPA shall have the right to revoke or
invalidate any examination score, with or without finding of fault or misconduct on my part, if data forensic analysis or other
credible evidence establishes a reasonable possibility that a score is not valid or that the integrity or security of the
examination was compromised.
SIGNATURE: __________________________________________________ DATE: ________________
Electronic signature agreement: In lieu of signature, you agree that typing your name on the line above is the legal equivalent of your
manual signature on this application.
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Certified Water-Based Systems Professional (CWBSP) Program Application
Payment Information
$350 (USD) Exam Fee
Total Amount Enclosed $_________________
Check. (Please make checks payable to NFPA Certification Department and mail to:
NFPA, Attn: Certification Dept, 1 Batterymarch Park, Quincy, MA 02169-7471)
Note: The most current published editions of NFPA 13, Automatic Sprinkler Systems Handbook, NFPA 13, Standard for the
Installation of Sprinkler Systems, NFPA 13D, Standard for the Installation of Sprinkler Systems in One- and Two-Family
Dwellings and Manufactured Homes, NFPA 13R, Standard for the Installation of Sprinkler Systems in Low-Rise Residential
Occupancies, NFPA 14, Standard for the Installation of Standpipe and Hose Systems, NFPA 20, Standard for the Installation
of Stationary Pumps for Fire Protection, and NFPA 22, Standard for Water Tanks for Private Fire Protection are available for
ordering through the NFPA printed catalog, on the Web at www.nfpa.org/catalog, or by phone at 1-800-344-3555.
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Copyright National Fire Protection Association, Inc. All rights reserved. Hard copies are uncontrolled and may not be up-to-
date. Users of hard copies should confirm the revision by comparing it with the electronically controlled version.
