Application for Certified Consulting Meteorologist

American Meteorological Society
45 Beacon Street, Boston, Massachusetts 02108-3693
Tel: (617) 227-2426 ext. 215
Fax: (617) 742-8718
E-mail: amsprof@ametsoc.org

Serving the Atmospheric and Related Oceanic and Hydrologic Sciences Since 1919

Please complete this entire application. Complete the enclosed Technical Experience Record. Please attach a separate sheet or resume listing education, technical affiliations, publications and distinctions. You will be required to do the following except as may be waived at the discretion of the Board of Certified Consulting Meteorologists: pass a written examination administered by the Board; submit to the Board five copies of a technical report in the field of meteorology prepared by you or under your direction; and pass an oral examination administered by the Board. Transcripts from universities and colleges, statements from references and supporting documents are to be submitted to the Board. A full description of the Certification Program for Consulting Meteorologists and application fees can be found in the most recent August issue of the Bulletin of the American Meteorological Society.

Name
Home Address		City	State	Zip code
Employer	Address	City	State	Zip code

Telephone numbers:

Home:

Office:

Fax:

My academic record which I submit in support of my application is as follows:

Academic Institution

Degree

Major

Year

I have requested registrars of the above academic institutions to forward transcripts of my records directly to the chairperson of the Board, c/o Executive Director.

I am a member of the following technical societies and have the following technical affiliations or distinctions: (engineering or scientific societies: give grade of membership, honorary scholastic or technical fraternities, prize or awards, honorary degrees, engineering registration, military or civilian citations for technical achievement, etc.)

My publications pertinent to this application are (with full bibliographic citations): - Attach a separate sheet to give a futher listing of publications.

TECHNICAL EXPERIENCE RECORD

PLEASE BE EXPLICIT as to your duties, character of work, its importance, and your degree of responsibility in connection with each engagement. On an attached sheet of paper, please submit your technical experience record using the guidelines listed below. Designate each separate engagement by letter (ex. a,b,c,...).

Each of the two columns under "Time" should be filled for each engagement. Use Zeros when necessary, but do not leave blank spaces.
The time in "Sub-Professional Work" (A) and the time in "Professional Work" (B) must be mutually exclusive.

Engagement

Date

From - To

TITLE OF POSITION, NAME OF EMPLOYER AND
CHARACTER OF EACH ENGAGEMENT

Make statement brief and concise, designating each engagement or change in position by a separate letter; include magnitude and complexity of work on which engaged, your duties and degree of esponsibility; any necessary amplification may be made on separate sheet.

Time (Years in Decimals to Tenths
(A) Sub- Professional Work	(B) Professional Work

NAME, TITLE AND ADDRESS

of some person (not deceased)
familiar with each engagement,
preferably the person to whom
applicant reported.

SUMMARY (actual time)

PLEASE DO NOT FILL IN SUMMARY (rated years or active practice)

Area of Specialization in Atmospheric and related Oceanic and Hydrologic Sciences:

Association or employment with Consulting Companies or Certified Consulting Meteorologists:

The following three persons have indicated their willingness to serve as references in support of my application. These persons are in one or more of the following capacities and at least one of the three should preferably be a Certified Consulting Meteorologist:

Department head or senior faculty member of the department of major study in academic institutions that I attended.
Official of a client company or institution or agency
A superior in my employing company, institution, or Governmental agency.
A Certified Consulting Meteorologist. (See August Bulletin for list.)

Name	Title	Mailing Address
A)
B)
C)

I authorize the chairperson of the Board of Certified Consulting Meteorologists to write directly to the above listed references for a statement concerning my qualifications. I also understand that the chairperson of the Board has the right to communicate with those persons and organizations which I have named in this application in regard to my qualifications for certification.

I agree that the granting of the Certificates for Consulting Meteorologists by the American Meteorological Society is made under procedures prescribed by the Council. I agree that my Certificate, if granted, may be revoked by the Council. I agree to abide by the decisions of the Council in all matters pertaining to the processing of my application for Certification, granting or denial of the Certification, or revocation of the Certificate if those bodies acting in due authority so decide that action is advisable. I hereby waive any right I may have by existing or future law, federal of state, to file suite against, recover damages, or recover court costs from the American Meteorological Society, the Board of Certified Consulting Meteorologists, or any member of a Board, Commission, or Council of the American Meteorological Society, in connection with my application for certification, the certification procedures, or renewal or revocation of Certification.

It is my understanding that my non-refundable application fee is to be applied to the expenses in processing my application and that this fee will be paid to the American Meteorological Society on receipt of the application. Certification is granted for a period of one year and is renewed annually. Renewals are billed by the American Meteorological Society in conjunction with annual membership and subscription notices. Finally, I understand that this professional certification program is a service offered by the American Meteorological Society in accordance with it's constitution and by-laws.

I certify that the information I have furnished above is complete and accurate. I agree to support the objectives of the Society and to abide by Article XII - Guidelines of Professional Conduct - of the Constitution of the American Meteorological Society.

Date: _____________________________ Signed: _______________________________________________________________