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Application Form
SSPC Concrete Coating Inspector Program and Certification
This form is to be filled out by the student taking the CCI Certification.
Document Checklist: A complete packet MUST be submitted to SSPC two weeks prior to the beginning
date of the course. The completed packet MUST include:
_____ Application Form
_____ Work Experience Form (Relevant work experience hours MUST be included)
_____ Picture for your wallet card (.jpg file of no more than 1 inch by 1 inch)
Send COMPLETE Application Packet to the SSPC Training Coordinator listed below:
Jeannine Bodack
40 24th Street, Sixth Floor
Pittsburgh, PA 15222-4656
Phone: 412-281-2331 x 2204
Fax: 412-281-9995
Email: bodack@sspc.org
Please take note: By filling out this form it does not register you for
the course. You must pay by check or credit card first before you are
officially registered for the course.
SSPC Member ID Number
Course Date__________________
Course Location____________________
Last Name_______________________________________
First Name_______________________________________
Middle Initial_______________________________________
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**Check off which “Path” you are
choosing to become CCI Certified.**
PATH 1
Six-Day Training and Certification Option
• Take the Two-Day Concrete Coating Basics Course (CCB) immediately prior to the FourDay Concrete Coating Inspector Program (CCI).
• You must pass the course exams and meet the experience prerequisites in order to take the
certification exam.
PATH 2
Coating Concrete Basics On-Line Exam Plus Four-Day Concrete Coating Inspector
Program (CCI) Option
• Take the Concrete Coating Basics (CCB) On-Line Exam, and attend the Four-Day Concrete
Coating Inspector Certification Program (CCI).
• You must pass the course exam and meet the experience prerequisites in order to take the
certification exam.
PATH 3
Concrete Coating Inspector Program (CCI) Four-day Program Only
• Those who have taken the SSPC Floor Coating Basics (C-10) or have previously taken the
Concrete Coating Basics Program (CCB) and have met the experience requirements can
proceed to the Four-day program.
PATH 4
Certification Exam Only Option (With Other Approved Certifications)
• Individuals who have PCI Certification; Frosio Level III or NACE CIP Level II may by-pass
the course and take the certification exam only.
PATH 5
Certification Exam Only Option (With Experience/No Training)
• Individuals who can document and verify at least 5 years or 7500 hours of concrete coating
inspection field work can take the CCI course exam then go on to take the Certification Exam
Prerequisites for Certification Level
*There are no prerequisites to attend the Technician Level of the Course.
Prior to going through the Certification Program, all individuals registering for the
SSPC Concrete Coating Inspector Program and Certification must provide information
showing that they meet the minimum requirements as set forth in this form. If SSPC is unable to
verify the accuracy of any information reported on this form, it may result in rejection of your
application.
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FOR PATHS 1, 2 and 3
Candidate submits an application to the SSPC Program Administrator (PA) along with the
completed Work Experience and Training Experience Form.
In order to qualify for the Certification Exam, the candidate must:
1. Successfully pass the Technician Level Exams with a score of 70% or higher.
2. Meet one of the following work experience and training requirements:
Please Check Off, which one applies to you, and submit the required items.
Work Experience (See Table 1)
Training Experience (See Table 2)
2 years or 3,000 hrs of coating/surfacing
concrete experience PLUS
40 hours of approved training
5 years or 7,500 hrs of coating/surfacing
concrete experience
n/a (You do not have to fill out the
training experience form if you are
doing this process.)
Table 1
Fieldwork experience must be in one of the following areas:
• Inspection of Coating/Surfacing Installations over Concrete
• Repairs, Surface Preparation and Installation of Coatings/Surfacings on Concrete
• Project Management of Coating/Installation of Coatings/Surfacing Concrete Projects
• Installation of Coating/Surfacing on Concrete Specification and/or Contract Development
• Coating Concrete Equipment and Material Supplier Technical Representative
• Failure Analysis of Coating/Surfacing Installation on Concrete
Table 2
For further information on other approved courses, please
contact Jennifer Merck at 1-877-281-7772, ext. 2221.
Approved 40 Hours of Additional Training
SSPC PCI Level 1 or greater
NACE CIP Level 1 or greater
Frosio Level 1 or greater
-Any successfully completed training course dealing primarily with coating/surfacing concrete offered by an
IACET-approved training organization or an accredited college or university or trade school.
-In addition, the student must have passed a written exam and the course must have been taught by a qualified
instructor as determined by the SSPC Individual Certification Program Administrator. A qualified instructor is
defined as a person who has similar qualifications to those qualified to instruct SSPC training courses.
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FOR PATH 4 -Certification Exam Only Option (With Training/No Experience)
Candidate submits an application to the SSPC Program Administrator (PA) along with the
completed Training Experience Form.
In order to qualify for the Certification Exam, the candidate must:
1. Successfully pass the Technician Level Exams with a score of 70% or higher.
2. The candidate is eligible to take the Certification Exam if they can document and verify that
they have taken at least a 80 hour training course that deals with coating/surfacing concrete.
See table 2.
For further information on other approved courses, please
contact Jennifer Merck at 1-877-281-7772, ext. 2221.
Table 2
Approved 80 Hours of Additional Training
SSPC PCI Certification
NACE CIP Level II
Frosio Level III
-Any successfully completed training course dealing primarily with coating/surfacing concrete offered by an
IACET-certified training organization or an accredited college or university or trade school.
-In addition, the student must have passed a written exam and the course must have been taught by a qualified
instructor as determined by the SSPC Individual Certification Program Administrator. A qualified instructor is
defined as a person who has similar qualifications to those qualified to instruct SSPC training courses.
FOR PATH 5-Certification Exam Only Option (With Experience/No Training)
Candidate submits an application to the SSPC Program Administrator (PA) along with the
completed Work Experience Form.
In order to qualify for the Certification Exam, the candidate must:
1. Successfully pass the Technician Level Exams with a score of 70% or higher.
2. The candidate is eligible to take the Certification Exam if they can document and verify at
least 5 years or 7500 hours of concrete coating inspection field work. See table 1.
Table 1
Fieldwork experience must be in one of the following areas:
• Inspection of Coating/Surfacing Installations over Concrete
• Repairs, Surface Preparation and Installation of Coatings/Surfacings on Concrete
• Project Management of Coating/Installation of Coatings/Surfacing Concrete Projects
• Installation of Coating/Surfacing on Concrete Specification and/or Contract Development
• Coating Concrete Equipment and Material Supplier Technical Representative
• Failure Analysis of Coating/Surfacing Installation on Concrete
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Prerequisite paperwork must be submitted to SSPC two weeks in advance of the program for
which you are registered. No certifications will be issued until after your paperwork has been
accepted by SSPC. The following forms must be turned into SSPC two weeks before the course.
•
•
Application
Work/Education History Form
Note: By my Initialing and signature below, I acknowledge that I have read and understand:
Initial: __________ The CCI Application Form and Instructions.
I do hereby certify that I have read and met the above prerequisites for the SSPC Concrete
Coating Inspector Certification.
Signed:
Printed Name and Title:
Date Submitted:
Note: Failure to report accurate, complete information will delay your application. Omission or
falsification of information or failure to answer all questions truthfully will result in withholding
or denial of certification status.
SSPC is concerned about protecting the confidentiality of our members. If you pass the course
exams or the certification exams your name and contact information will be placed on our
website.
Would you want your information posted on our website? Please check one of the boxes below.
Yes:
No:
If you do not check one of the boxes then your information will not be listed on the SSPC
website.
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