8/13/2019 OE 09028 OE Examination Application 12.12 (Received December 21, 2012)

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Full Name of ApplicantLast Name First Name Initial

Street No. Street Name

City Province Postal Code

Date of Birth:Month Day Year

Current Certificate No. (if applicable) Service Request No. (if applicable)

Telephone No. Daytime (work) Cell No.

E-mail

Method of Payment: Cheque or Credit Card Non-refundable examination fee $75.00

Changes to the application will be accepted if made in writing only, by sending an e-mail toexaminationandcertification@tssa.orgtwo (2) weeks prior to the examination date.

Operating Engineers: Please check () appropriate exam.

4thClass: 4A 4B

3rdClass: 3A-1 3A-2 3B-1 3B-2

* 2ndClass: 2A-1 2A-2 2A-3 2B-1 2B-2 2B-3

* 1st Class: 1A-1 1A-2 1A-3 1A-4 1B-1 1B-2 1B-3 1B-4

* Specify OLD or NEW Material.

Plant Operators: Please check () appropriate exam.

Refrigeration Operator Class B: RB-1 RB-2 Refrigeration Operator Class A: RA-1 RA-2

Compressor Operator: C-1 C-2 Steam Traction Operation: T-1

Certificate Re-instatements: Please check () appropriate exam.

Operating Engineer (all levels) Refrigeration Operator (B or A) Compressor Operator

Is this a re-write? NO YES: First Second Other: _________________________________

Date of Examination/Time: _________ ________ ________ Location (City): _________________________(Month) (Day) (Year)

Applicant Signature Date

This examination application is valid for a period of 6 months from the above date.

OE 09028 (12/12) Page 1 or 2 See guidelines on page 2.

TechnicalStandards andSafety Authority

www.tssa.org

Operating EngineersExamination Application

Technical Standards and Safety ActOperating Engineers Regulation

14th

Floor - Centre Tower3300 Bloor Street WestToronto, Ontario M8X 2X4Fax: 416.231.4903Customer Service: 1.877.682.8772E-mail: examinationandcertification@tssa.org

Please print and fax back this completed fo rm to Examination Services (416) 231- 4903

8/13/2019 OE 09028 OE Examination Application 12.12 (Received December 21, 2012)

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PROCEDURES FOR OPERATING ENGINEERS EXAMINATIONSForm No. OE 09028

Registration:

To write an examination at your local MTCU Centre (Ministry of Training, Colleges and Universities/TSSA in Ontario) .Complete the application and attach the exam fee of $75.00 (non-refundable/payable to TSSA).

Mail the application directly to: Examination ServicesTechnical Standards and Safety Authority14thFloor, Centre Tower3300 Bloor Street West, Toronto, ON M8X 2X4

send by FAX to: (416) 231-4903 If paying by Credit Card, please submit 15 business days prior to thescheduled examination date.

oremail to: examinationandcertification@tssa.org

Due to a limited number of seats, applications will be accepted on a first come ,first served basis. Changes to the

application will be accepted if made in writing only, by sending an e-mail to examinationandcertification@tssa.orgtwo (2)weeks prior to the examination date.

Candidates will be allowed to "re-schedule" an examination only once at no charge, but must notify TSSA via e-mail toexaminationandcertification@tssa.orgtwo (2) weeks prior to the examination date. This time period is required toprevent examinations from being forwarded to the Centre and avoid misinterpretation. Failure to do so will result inforfeiture of the examination fee and a new application form (with fee) will be required.

Candidates who have not registered are not allowed to write the examination on a scheduled examination date.

Examination Day:

On the day of the examination, applicants will be required to produce 1 piece of photo ID, e.g., Drivers Licence / Passport.

Test centres will provide the required reference material, e.g., Formulae booklets, Steam and Refrigeration Table, Acts,Regulations and Codes, Scientific calculators and pencils/eraser for use. Candidates are only allowed to bring into theexamination room writing and drawing items. Personal notes/reference materials are not allowed.

Re-writes:

An applicant who has not passed may re-write the examination sixty-days (60) after the previous sitting.

Notification:

The examinee will be notified of the results by mail within 30 working days after writing the examination.

OE 09028 (12/12) Page 2 or 2