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Lightning Protection Institute

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Online Test Registration Form

$0.00

Register for your Master Installer Test Series certification exams or your Designer/Inspector Test Series certification exams online.

(each individual applicant must fill out a separate form, we will not accept multiple applicants on the same registration)

Price: $0.00

First Name: *

Middle Initial: *

Last Name: *

Address: *

Phone Number: *

Fax Number: *

Email Address: *

Date of Birth: *

MM/DD/YYYY

Last 4 SSN: *

Current Employer: *

Job Title: *

Is your employer a member of the LPI?: *

No

Yes

Employer's City: *

Employer's State: *

Employer's Zip: *

Education Level (check one): *

High School Diploma

Trade or Technical School

College/University Degree

Post-Graduate Degree

Other

Full Name of Proctor: *

Mailing Address: *

City: *

State: *

Zip: *

Proctor Employer: *

Job Title/Position: *

Phone Number: *

Description of Experience: *

Please give a brief description of your experience in lightning protection

1. My work experience in lightning protection installation, systems design and/or estimating totals : *

Total number of months

2. My work experience in a related building trade, such as roofing, siding, carpentry, plumbing, etc., totals: *

Total number of years

3. My work experience as an electrician totals: *

Total number of years

Please describe any home study courses, seminars or workshops you have completed or attended, including names, dates and places: *

Journeyman Installer Test #1: *

No

Yes

Journeyman Installer Test #2: *

No

Yes

Master Installer Test #1: *

No

Yes

Master Installer Test #2: *

No

Yes

Master Installer/Designer Test: *

No

Yes

Designer Inspector Test #1: *

No

Yes

Designer Inspector Test #2: *

No

Yes

Yes, I am employed by an LPI member company or I am a current LPI professional member. * If neither of these options apply you must checkmark “Not applicable” to proceed.: *

Not applicable

1 Tests, +$103.00

2 Tests, +$206.00

3 Tests, +$309.00

4 Tests, +$412.00

5 Tests, +$515.00

(LPI member company employees receive a 50% discount on all certification testing)

No, I am not employed by an LPI member company. If you already indicated a member test option above you must checkmark “Not applicable” to proceed: *

Not applicable

1 Test, +$206.00

2 Tests, +$412.00

3 Tests, +$618.00

4 Tests, +$824.00

5 Tests, +$1,030.00

I certify that all answers I have provided on this Registration Form are complete and factual: *

(your typed name will serve as your electronic signature)

P.O. Box 99 Maryville, MO 64468|Toll Free: 1 (800) 488-6864|LPI@lightning.org

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