APPLICATION FOR POWER ENGINEERS EXAMINATION

AB-66 (Part A1) 2013-01

1. TO BE COMPLETED BY APPLICANT: (Please Print)

Mr. Mrs.

File No:
(for previous applicants only)

Name of Applicant: Mailing Address:

Ms.
(Lastname) (Firstname) (Middle Initial)

Date of Birth:
(yyyy/mmm/dd)

(Apt./Street)

(City)

(Prov)

(Postal Code)

Phone No.:
(Home)

Phone No.:
(Work)

Cell No.:

E Mail Address:

Indicate below the examination you are applying to write:

Part A
Paper

Part B
Paper

Upgrades

Class Rev. 1st Rev 2nd 3rd 4th 5th

4th to New 4th 2nd to 1st th BOA to New 4 3rd to 2nd th BOB to 5 4th to 3rd th Fireman to 5 5th to 4th Reinstatements CLASS 1 2 3 4 5

Special Boiler Operator (SBO) *Special Oilwell (SOW) use form AB-144

Indicate the location and month you wish to write the exam. Please indicate 1st and 2nd choice: Edmonton Fort McMurray Calgary Red Deer Lethbridge Medicine Hat Grande Prairie Jan July
Note:

Feb Aug

Mar Sept

Apr Oct

May Nov

June Dec

Available places are allocated on a first come basis, therefore you may not be guaranteed the date(s) of your choice. SOPEEC Exams are protected by copyright. A candidate who shares any SOPEEC examination questions or parts thereof with other in any format may be subjected to disqualification of the exam paper written and certification as well as a penalty from writing another examination for up to twelve months.

Signature of Applicant:

Date:
yyyy/mmm/dd

Caution: Certificate issued may be cancelled or suspended for false statements or documentation included in this application. A non-refundable/non-transferable scheduling fee of $97.00 per paper is required with this application. NSF cheques subject to a $25 charge. Please fax, e-mail or mail application with payment. Please do not do both. Payment can not be made by phone. Cheque payable to: Amount: Cardholder Name: Cash , Cheque , M/C , Visa , Debit

ABSA, the pressure equipment safety authority

9410 20 Avenue Edmonton, AB T6N 0A4 Phone (780) 437-9100 Fax (780) 437-7787 Exams Toll Free Line - 1-888-454-3926 www.absa.ca email to: exams@absa.ca Cardholder Signature:
th

Card Number: Expiry Date:

ABSA Use only Auth. #

APPLICATION MUST BE SUBMITTED A MINIMUM OF 21 DAYS PRIOR TO EXAMINATION DATE

APPLICATION FOR POWER ENGINEERS EXAMINATION

AB-66 (Part B1) 2012-05

Name of Applicant:
(Lastname) (Firstname) (Middle Initial)

File No:
(for previous applicants only)

Declaration of the Applicant s Experience

2. To be completed by Chief Steam Engineer or Company Official: Company Name: Plant Location: Type of Plant: Power Plant Pressure Plant Boiler Kilowatts Rating: Boiler Pressure: Steam Water AAFor College Use Only Controlled Practicum Experience
(yy/mm/dd)

Plant Name:

Heating Plant Thermal Liquid Heating System

ABSA Boiler Wall Certificate Number: AAAAApplicant s Operating Experience: From:

(yy/mm/dd)

To: months as months as months as position position position

College Name: Program Name:

4 / 3 / PET
th rd

Student Hours
(From Timesheet)

Practicum Coordinator:

Positions are: Chief Power Engineer, Shift Engineer, Assistant Shift Engineer, Assistant Engineer, Process Operator(Note 1), Heating Plant Operator, Power Engineer in Charge and Thermal Liquid Heating System Operator. Note 1: When experience as a process operator is being used towards an Engineer s Certificate of
Competency, it will be necessary for the applicant to submit with this application a resume of the equipment operated, including the duties and responsibilities, signed by the Chief Power Engineer or a Company Official.

Name of Chief Power Engineer/Company Official: Position Work Phone: Work Email Address: Signature: Date: File Number (if applicable): Fax:

The information you provide is necessary for the administration of the programs as required by the Alberta Safety Codes Act and Regulations in the Boiler Discipline.