EPI Application Form Step 1 of 5 - Applicant Data 20% Applicant Data The Board for Global EHS Credentials (BGC®) administers the Qualified Environmental Professional (QEP®) credential and the Environmental Professional In-Training (EPI®) designation. The EPI® is an optional entry-level designation aimed at the following individuals: seniors in an accredited, recognized college or university who are working towards a technical baccalaureate/masters degree in physical, earth or natural sciences, engineering, or mathematics; OR individuals who have received a baccalaureate/masters degree in one of the above-mentioned disciplines within the last five years and have entered, or anticipate entering, the environmental profession. An EPI Candidate Handbook is available on this website for all exam applicants. The handbook provides an overview of subject matters on the test and sample questions. The handbook also contains specific information on the certification process as well as BGC's Policies and Procedures concerning certification and the examination. The application fee is US$80.00. If you are approved to sit for the EPI exam, the exam fee is US$250 for the QEP Part 1 General Environmental Science Exam. BGC reserves the right to verify all information submitted in this application. If you believe you are a reapplicant, please do not complete the rest of this form. Please contact our office at applications@GoBGC.org. Name(Required) First Middle Last Please indicate any previously-used last / surnames.Previous Name*Please advise BGC if your legal name has changed since graduating from a college or university. Documentation of name changes must be sent to BGC at applications@GoBGC.org. AddressesPlease choose your primary address.Choose Address(Required)Use Home AddressUse Work AddressCompany NameDivisionBusiness Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Business CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench 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CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home PhoneHome business Have you applied to BGC previously? Have you applied to BGC previously?(Required) No Yes If yes, for which credential? Credential Applied ForDate Previously Applied MM slash DD slash YYYY Education An official transcript sent directly from each U.S. college or university attended is required. You may also send official transcripts in an envelope sealed with the Registrar’s seal. See the QEP Candidate Handbook pages on this website for requirements about equivalency reports needed for international degrees awarded outside of the U.S./Canada. Degree 1(Required)Major 1(Required)School 1(Required)Date Awarded 1(Required) MM slash DD slash YYYY Degree 2Major 2School 2Date Awarded 2 MM slash DD slash YYYY Degree 3Major 3School 3Date Awarded 3 MM slash DD slash YYYY College/university transcripts is/are being forwarded. Select: Transcripts Forwarded?(Required)YesNoApplicants with degrees from outside the U.S. and Canada will be required to submit their transcript(s) for a credential evaluation unless the academic program is authorized by BGC or through a BGC-recognized accreditation agency to issue BGC verification statements. Record of Work Experience Directions: Provide details on principal professional responsibilities, highlighting environmental-related work (environmental-protection-related work, defined as paid employment that uses skills learned in an applicant's formal college education capabilities). Include, where applicable, a description of the extent of your involvement in, or understanding and awareness of, multi-media issues as they pertain to each position. You may upload an annotated resume in addition to this Record of Work Experience. You can view an example of how to complete this form. Summary of WorkSingle Line Text(Required)Single Line TextSingle Line TextSingle Line Text Date From:Date From 1(Required) MM slash DD slash YYYY Date From 2 MM slash DD slash YYYY Date From 2 MM slash DD slash YYYY Date From 2 MM slash DD slash YYYY Date To:Date To 1(Required) MM slash DD slash YYYY Date To 2 MM slash DD slash YYYY Date To 3 MM slash DD slash YYYY Date To 4 MM slash DD slash YYYY Title of position, name of employer, duties, degree of responsibility, and other relevant information for each significant assignment. Make statements clear and concise but specific.Paragraph Text 1(Required)Paragraph Text 2Paragraph Text 3Paragraph Text 4Duration of Professional Activity (Years/Months)Text Years 1(Required)Text Years 2Text Years 3Text Years 4 Names(s), Titles(s), and Address(es) or person(s) familiar with your work (if available) Paragraph Text References 1(Required)Paragraph Text References 2Paragraph Text References 3Paragraph Text References 4How many years of professional environmental experience are documented on your Record of Work Experience above?Number of years of professional experience(Required)Text: Explain Other CategoryNo relevant professional work experienceNo relevant professional work experience(Required) YES NO References Individuals applying for an EPI designation must provide three references from environmental professionals. Who acceptable references are depends on whether you are a new graduate or have actual work experience. Student and recent graduates must minimally have references submitted from environmental professionals, typically professors or environmental course instructors, who are familiar with their academic abilities and achievements. Applicants for the EPI who also have actual environmental work experience are encouraged to obtain at least one reference from supervisors, clients or others who can attest to your work experience. Business partners, immediate subordinates, or relatives cannot write a reference for you. It is your responsibility to provide the link to the Professional Reference Questionnaire (PRQ) form to those individuals listed below. Your application is not final until all completed PRQs are received by BGC. Note: *General definition of the term "responsible charge" refers to a leadership role or position of influence held in direct relationship to work assignments, job responsibilities, and to key roles in the projects or program assigned. Name, Title, and Affiliation of Reference Reference Name 1(Required)Reference Title 1(Required)Reference Affiliation 1(Required)Reference Name Title Company/Organization Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. AgreementsHave you ever been criminally convicted of a misdemeanor or felony?Have you ever been criminally convicted of a misdemeanor or felony?(Required) No Yes Have you ever had a professional license or certification revoked?Have you ever had a professional license or certification revoked?(Required) No Yes Have you ever had a certification granted by a non-governmental organization revoked?Have you ever had a certification granted by a non-governmental organization revoked?(Required) No Yes If you answered "yes" to any of the above, then please contact BGC at applications@GoBGC.org. Answering "yes" does not automatically prevent an individual from obtaining the QEP certification, but the specific circumstances involved will be thoroughly reviewed by the BGC Admissions Committee.I understand that it is my responsibility to send the link to the Professional Questionnaire Form (PRQ) link to my references; BGC does not make an initial contact.PRQ To References Choice(Required)NoYesPer the EPI Candidate Handbook pages on this website, I understand the following: Official transcripts must be submitted for each degree. An “official” transcript is one sent directly to BGC by your college or university through mail or as secure e-transcripts. Alternatively, you may submit official transcripts if they are in a sealed envelope with the Registrar’s stamp across the seal. If your transcripts have a name different from the name under which you are applying, please submit documentation of the name change to applications@GoBGC.org (e.g. marriage certificate, divorce decree, etc.). When a degree includes credits that were transferred from another college or university, official transcripts for those course credits must be sent upon request. Email address for transcripts: applications@GoBGC.org. Physical address for transcripts: BGC, ATTN: QEP, 6005 W. St. Joseph Hwy Ste 300, Lansing, MI 48917 USA. Transcripts to BGC Choice(Required)NoYes I hereby agree to indemnify and hold harmless each and all of the BGC Board members, officers, committee members, staff, and its agents from and against any liability whatsoever in respect to any act(s), error(s), or omission(s) by them in connection with this application, the examination, the evaluation of such examination, or the granting or issuance of or failure to grant or issue a certificate to me, and that any certificate granted or issued to me shall remain the property of the BGC. Code of Ethics I understand that I am subject to the terms and conditions set out for my application in the EPI Candidate Handbook pages on the BGC website in effect at the time of application. I agree to adhere, to the best of my ability, to the BGC Code of Ethics and be governed by the Ethics Case Procedures as published on the BGC website. I further pledge to: Practice my profession only to the extent of my personal expertise. Maintain my personal proficiency through continuing education and professional development. Comply with applicable statutes, regulations, and standards. Strive to protect and enhance human health and the environment. Contribute to the development of other professionals. Conduct my professional affairs in a manner that reflects the highest moral character. I certify that the information and documents that I submit are, to the best of my knowledge, accurate and truthful. I understand that any falsification in this application will be grounds for rejection or for later revocation of any certificate issued. I give permission to BGC to contact my past supervisors and references as listed herein. I also recognize my obligation not to reveal the contents of the EPI Examination. I agree that any prescribed application and examination fee(s) paid by me are not refundable, and if I become certified, I understand that I am obligated to pay annual EPI maintenance fees. I agree to use electronic records and signatures.(Required) I agree to use electronic records and signatures. Typed Signature(Required)Date MM slash DD slash YYYY Email(Required) Enter Email Confirm Email BGC does not discriminate among applicants as to age, sex, race, religion, national origin, disability, or marital status.I am submitting a Test Accommodation Request for a disability covered by the Americans with Disabilities Act as amended or other applicable laws.Test Accommodation Choice(Required)NoYes EPI Candidate Handbook About the EPI Overview of Steps Reapplicants Eligibility Requirements Documents Needed Application and Exam Fees Exam Overview Exam Preparation Exam Scheduling Exam Day Documents and Forms Apply Now Applicants Payments