Copy of NEW_OCNT_Applications by tamir13

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									                                                 OHIO CERTIFIED NURSERY TECHNICIAN
                                      GARDEN CENTER TEST APPLICATION
                                            Monday, January 26, 2009, 9:00 a.m.
                                      Franklin Rooms, Hyatt Regency Hotel, Columbus

                           THIS FORM MUST BE RECEIVED, ALONG WITH PAYMENT, BEFORE 5 P.M.,
                       WEDNESDAY, JANUARY 7, 2009. THERE WILL BE NO EXTENSION OF THIS DEADLINE.
                            Please complete a separate copy of this form for each applicant. Please print or type.
                                                Please make copies of this form as needed.

       NAME:
       HOME ADDRESS:                                                                                  EMAIL:
       CITY:                                                                    STATE:                ZIP:               PHONE:
       COMPANY NAME:
       ADDRESS:
       CITY:                                                                    STATE:                ZIP:               PHONE:
REQUIRED




                                                                          EMPLOYER’S STATEMENT:
            I confirm that the above applicant meets the OCNT eligibility requirements:
            ♦ Worked 1000 hours in the Green Industry or
            ♦ Worked 500 hours in the Green Industry and is currently enrolled in or has successfully completed a recognized Horticultural Program (i.e.:
               college or high school) or
            ♦ Worked 1500 hours as a volunteer in the Green Industry at an arboretum, botanical garden or as a master gardener


            Employer Name: _______________________________________________ Signature:___________________________________________




       FIRST-TIME TEST FEES: (ONLA will verify membership)                              SPECIAL NEEDS: (ONLA staff will contact you.)
                ONLA Member:           $35.00 Per Individual                                    I have a special need or disability which may require special
                Non-member:            $70.00 Per Individual                                    accommodations for taking the exam.

       RETEST FEES: (NOTE: The retest must be taken within one year of                  PAYMENT METHOD:
       the original test date to qualify for the retest fee.)                                    Check            VISA               MasterCard
       Previous test date:
                                                                                       Card Number:
              ONLA Member:             $30.00 Per Individual
              Non-member:              $60.00 Per Individual                           Exp Date:
       NO SHOW:
                                                                                       Card Holder:
                I was registered for and missed the August 2008 Garden Center
                Exam. No Charge if this is the first time you’ve missed this exam.     Signature:

                                                                ADDITIONAL INFORMATION
           Attendees should arrive 15 minutes prior to testing time! NO ONE will be admitted after the classroom doors have closed.
           After sending payment, you will receive a copy of this form stamped “CONFIRMED.” You must bring this copy and Photo I.D.
           with you to the testing site. No refunds will be given after the application deadline. Questions? Call the ONLA at (800) 825-
           5062 or (614) 899-1195.
                                                Return registration with payment to:
                       The Ohio Nursery & Landscape Association, 72 Dorchester Square, Westerville, Ohio 43081;
                                                Fax: (614) 899-9489 or (800) 860-1713.
                                                 OHIO CERTIFIED NURSERY TECHNICIAN
                                                 GROWER TEST APPLICATION
                                            Tuesday, January 27, 2009, 9:00 a.m.
                                      Franklin Rooms, Hyatt Regency Hotel, Columbus

                           THIS FORM MUST BE RECEIVED, ALONG WITH PAYMENT, BEFORE 5 P.M.,
                       WEDNESDAY, JANUARY 7, 2009. THERE WILL BE NO EXTENSION OF THIS DEADLINE.
                            Please complete a separate copy of this form for each applicant. Please print or type.
                                                Please make copies of this form as needed.

       NAME:
       HOME ADDRESS:                                                                                  EMAIL:
       CITY:                                                                    STATE:                ZIP:                PHONE:
       COMPANY NAME:
       ADDRESS:
       CITY:                                                                    STATE:                ZIP:                PHONE:
REQUIRED




                                                                          EMPLOYER’S STATEMENT:
            I confirm that the above applicant meets the OCNT eligibility requirements:
            ♦ Worked 1000 hours in the Green Industry or
            ♦ Worked 500 hours in the Green Industry and is currently enrolled in or has successfully completed a recognized Horticultural Program (i.e.:
               college or high school) or
            ♦ Worked 1500 hours as a volunteer in the Green Industry at an arboretum, botanical garden or as a master gardener


            Employer Name: _______________________________________________ Signature:___________________________________________




       FIRST-TIME TEST FEES: (ONLA will verify membership)                               SPECIAL NEEDS: (ONLA staff will contact you.)
                ONLA Member:           $35.00 Per Individual                                    I have a special need or disability which may require special
                Non-member:            $70.00 Per Individual                                    accommodations for taking the exam.

       RETEST FEES: (NOTE: The retest must be taken within one year of                   PAYMENT METHOD:
       the original test date to qualify for the retest fee.)                                     Check            VISA               MasterCard

       Previous test date:                                                               Card Number:
              ONLA Member:             $30.00 Per Individual
              Non-member:              $60.00 Per Individual                             Exp Date:

       NO SHOW:                                                                          Card Holder:
                I was registered for and missed the August 2008 Grower Exam.
                No Charge if this is the first time you’ve missed this exam.             Signature:

                                                                ADDITIONAL INFORMATION
           Attendees should arrive 15 minutes prior to testing time! NO ONE will be admitted after the classroom doors have closed.
           After sending payment, you will receive a copy of this form stamped “CONFIRMED.” You must bring this copy and Photo I.D.
           with you to the testing site. No refunds will be given after the application deadline. Questions? Call the ONLA at (800) 825-
           5062 or (614) 899-1195.
                                                Return registration with payment to:
                       The Ohio Nursery & Landscape Association, 72 Dorchester Square, Westerville, Ohio 43081;
                                                Fax: (614) 899-9489 or (800) 860-1713.
                                                 OHIO CERTIFIED NURSERY TECHNICIAN
                                             LANDSCAPE TEST APPLICATION
                                          Wednesday, January 28, 2009, 9:00 a.m.
                                      Franklin Rooms, Hyatt Regency Hotel, Columbus

                           THIS FORM MUST BE RECEIVED, ALONG WITH PAYMENT, BEFORE 5 P.M.,
                       WEDNESDAY, JANUARY 7, 2009. THERE WILL BE NO EXTENSION OF THIS DEADLINE.
                            Please complete a separate copy of this form for each applicant. Please print or type.
                                                Please make copies of this form as needed.
       NAME:
       HOME ADDRESS:                                                                                  EMAIL:
       CITY:                                                                    STATE:                ZIP:                 PHONE:
       COMPANY NAME:
       ADDRESS:
       CITY:                                                                    STATE:                ZIP:                 PHONE:
REQUIRED




                                                                          EMPLOYER’S STATEMENT:
            I confirm that the above applicant meets the OCNT eligibility requirements:
            ♦ Worked 1000 hours in the Green Industry or
            ♦ Worked 500 hours in the Green Industry and is currently enrolled in or has successfully completed a recognized Horticultural Program (i.e.:
               college or high school) or
            ♦ Worked 1500 hours as a volunteer in the Green Industry at an arboretum, botanical garden or as a master gardener


            Employer Name: _______________________________________________ Signature:___________________________________________




       FIRST-TIME TEST FEES: (ONLA will verify membership)                               SPECIAL NEEDS: (ONLA staff will contact you.)
                ONLA Member:           $35.00 Per Individual                                     I have a special need or disability which may require special
                Non-member:            $70.00 Per Individual                                     accommodations for taking the exam.

       RETEST FEES: (NOTE: The retest must be taken within one year of                   PAYMENT METHOD:
       the original test date to qualify for the retest fee.)                                      Check            VISA              MasterCard

       Previous test date:                                                               Card Number:
              ONLA Member:             $30.00 Per Individual
              Non-member:              $60.00 Per Individual                             Exp Date:

       NO SHOW:                                                                          Card Holder:
                I was registered for and missed the August 2008 Landscape Exam.
                No Charge if this is the first time you’ve missed this exam.             Signature:


                                                                ADDITIONAL INFORMATION
           Attendees should arrive 15 minutes prior to testing time! NO ONE will be admitted after the classroom doors have closed.
           After sending payment, you will receive a copy of this form stamped “CONFIRMED.” You must bring this copy and Photo I.D.
           with you to the testing site. No refunds will be given after the application deadline. Questions? Call the ONLA at (800) 825-
           5062 or (614) 899-1195.
                                                Return registration with payment to:
                       The Ohio Nursery & Landscape Association, 72 Dorchester Square, Westerville, Ohio 43081;
                                                Fax: (614) 899-9489 or (800) 860-1713.

								
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