Certified Pool/Spa Operator Application

Please submit application and course certificate. Fee is $20.00 per year with a maximum of $60.00 for 3 years.

"*" indicates required fields

Name of Applicant:*

First Last

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Name of pool/spa operating at:*

Current certification # from another County:

(No Fee Required)

Type of Pool:*

Public

Semi-Public

SELECT OPTION BELOW FOR BEING CERTIFIED*

New, completed 14 hour approved pool and spa operator course with minimum grade of 75%

Re-certification, present proof of previous certification and completed an approved 4 hour refresher course

*** COPY OF COURSE COMPLETION DOCUMENTATION REQUIRED ***

Please Attach a Copy of Course Completion Documentation*

Accepted file types: jpg, png, tif, pdf, Max. file size: 50 MB.

Attach a clear image or pdf.

Comments

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