QEP Application Form for those who hold a CIH

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.

List below the name, title, and company of at one environmental professionals who has personal knowledge of your professional work and can substantiate and provide an evaluation of "time in responsible charge"* of environmentally-related work.

Business partners, immediate subordinates, or relatives cannot write a reference for you.

It is your responsibility to provide the link to the QEP Professional Reference Questionnaire (PRQ) form to those individuals listed below. 

Your application is not final until this completed PRQ is 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

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.

Code of Ethics

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.

I understand that I am subject to the terms and conditions set out for my application in the QEP 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 QEP 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 QEP maintenance fees. 

BGC does not discriminate among applicants as to age, sex, race, religion, national origin, disability, or marital status.