|
Historic Building Inspectors Association
~ Membership Application ~ |
Name:
________________________________ |
Company:
_____________________________________ |
Bus. Address:
________________________________
________________________________ |
Bus. Phone: ___________________
Bus. Fax: ____________________ |
| Website: ____________________ |
E-Mail: __________________ |
|
1. Have you passed the National
Home Inspector Exam? ________ Date: __________
or the NAHI CRI Exam? ________ Date: __________
|
2. Have you completed at least
200 fee paid inspections? ________
|
3. Do you hold valid State or
Municipal Home Inspector's License(s)
in the areas you service? ________ . Not Applicable:
___
| - Please list State/Municipality and License Number if
applicable: |
| State/Municipality |
License # |
State/Municipality |
License # |
| _____________ |
_____________ |
_____________ |
_____________ |
| _____________ |
_____________ |
_____________ |
_____________ |
|
4. Have you earned 16 hours of
continuing education credits last year? ________
| ASHI® |
MRC's: ______ |
| NAHI™ |
CEU's ______ |
| State: _______ |
CEU's ______ |
|
5. Are you, or have you been,
actively involved in historic preservation ________,
(This includes paid or volunteer service as a
Board member, director,
consultant or advisor to a
public historic site, historic district or society).
Please list name, and contact info of
the historic site, district or society:
_______________________________________________________________
|
| AND/OR |
Have you
earned a Certificate in Preservation Skills and Technology? ________
|
| AND |
Other
involvement with historic preservation (in addition to the
above):
_________________________________________________________________
|
6. Are all your reports prepared
and delivered in a narrative style format? ________
|
7. Do your inspections and
reports meet ASHI® or
NAHI™ Standards?
________
|
I, the undersigned applicant, hereby declare
that the information contained in this application is true and agree to submit
verifiable proof and documentation if requested. If approved for membership, I
also agree to uphold the Standards of Practice and Code of Ethics as defined by
my State license requirements or ASHI® or
NAHI™.
I hereby agree to hold the Historic Building Inspectors
Association, it's members, board, committee members or director harmless in the
event of rejection of membership for any reason. I further agree to hold the
Historic Building Inspectors Association and it's entire membership harmless in
the event of a claim or proceeding arising out of the performance of an
inspection or consultation for clients referred to me by other members, the
website or from any other promotional materials of the Association.
|
Please mail application
to:
Historic Building
Inspectors Assoc.
PO Box 201
Springtown, PA 18081 |
|
Signature:
_______________________ Date:__________
Membership dues, other reports or documents
should ~NOT~ be sent with this application. |