Subject Matter Expert Nomination

If you are a highly experienced craftsperson who is committed to improving the training and assessment tools used by a safe, effective, and sustainable workforce of craft professionals, NCCER would like to have you on our team!

Name of nominated expert*

What is the nominee's current job title?*

NCCER wallet card number (if available)

Tell us how to contact the nominee:

Phone*

Fax

E-mail*

Mailing Address*

Physical Address (if different)

City*

State*

ZIP*

Is this a residential or business address?*

Residential Business

Craft Committee(s)

Please list committee(s) the nominee should be considered to serve on*
("Carpentry, Rigging, Project Management")

How many years experience does the nominee have in each craft above?*
("16, 12, 8")

States in which the nominee has worked*

Is the nominee familiar with the NCCER craft curriculum?*

Yes No

Is the nominee an NCCER Certified Craft Instructor?*

Yes No

Is the nominee fluent in languages other than English?*

Yes No

If so, please indicate the languages spoken

Does the nominee have teaching experience?*

Yes No

If so, how many years?

Is the nominee familiar with NCCER's journey-level certifications?*

Yes No

If part of the pipeline industry, is the nominee familiar with the NCCER OQ process?*

Yes No N/A

If in a licensed craft, does the nominee hold a current license?*

Yes No N/A

Please list any certifications held by the nominee related to the craft areas of expertise or for teaching/training

Sponsoring Orgainization

Employer
(If different from Sponsoring Organization)

Name of immediate supervisor*

Supervisor's Phone*

Supervisor's e-mail

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