io n al NGWA SM G ro ess The Groundwater Association u r of C e r t i fi e d Certified Groundwater Professional (CGWP) Request for Professional Development Credits (PDCs) rP n d w ate CGWP # _________________________________ Name _____________________________________________________________________________________ Address____________________________________________ City____________ State/Province___________ Country________ Zip/Postal code__________ CGWPs will be required to obtain professional development credits (PDCs) to maintain active status. Thirty-six (36) credits will be required by December 31 for every three-year anniversary period. Please complete the appropriate section(s) and supply copies of the necessary accompanying materials (copies will not be returned). 1. Attendance at local, regional, national, and international technical meetings (NGWA, GSA, AGU, etc.). Three (3) credits per day of attendance or appropriate fraction thereof. Remit a copy of the program agenda and registration. Meeting name Location Date(s) # Days Credit(s) 2. Participation in, or teaching of, short courses/workshops (NGWA, GSA, universities, government training, etc.). Four (4) credits per day of participation or appropriate fraction thereof. Remit a copy of the program agenda and registration and/or speaker topic outline. Course name Location Date(s) # Days Credit(s) 3. Publication in refereed journals (Groundwater®, GSA Bulletin, Water Resources Research, etc.). Eight (8) credits per published article. Remit a copy of the article (proof of review for nonjournal items required). Title Journal Volume # Date 4. Teaching at universities, colleges, or junior colleges, where not normally employed. Two (2) credits per one semester or quarter hour. Remit a copy of the course description and speaker contract. University Course name Credit hours Credit(s) Page(s) 5. Enrollment and attendance at university or college courses in relevant subjects. Seven (7) credits per semester credit unit earned. Five (5) credits per quarter credit. Remit a copy of the course description and your official transcript. University Course name Credit hours Credit(s) Date Credit(s) 6. Oral presentation of papers at technical society meeting. Four (4) credits per paper presented. Remit a copy of the program agenda. Meeting name Location 7. Participation in, or presenting of, a groundwater-related webinar. Four (4) credits per webinar presented. Two (2) credits per webinar participation. Remit receipt of purchase and outline of topics covered. Webinar title Presenter Date Credit(s) Please note: Credit may be given only once for each function under only one section of this form, (i.e., if a conference was attended at which you gave a presentation, credit is given for the day of the presentation under #5 and additional days of attendance at the meeting are given under #1.) In addition, programs/agendas/articles, etc. need not be presented for NGWA meetings and publications, but proof of numbers of days of attendance is required. Please return to: NGWA Certified Groundwater Professional Program 601 Dempsey Rd. Westerville, OH 43081 Fax: 614 898.7786 / Email: certification@NGWA.org NGWA SM The Groundwater Association Address 601 Dempsey Road, Westerville, Ohio 43081-8978 U.S.A. Phone 800 551.7379 • 614 898.7791 Fax 614 898.7786 Email ngwa@ngwa.org Websites NGWA.org and WellOwner.org