Laboratory Analyst Certification Application - NEWEA - New England Water Environment Association

Laboratory Analyst Application

Please note that this application must be completed at one time. There is no option to save. Required fields are noted with a red *.

Step 1 of 4

Name*
First Middle Last
Mailing Address:*
Street Address Address Line 2 City State ZIP Code
Best Number to reach you*
Email*

Select the grade level you are applying for.*
Please note that Lab Analyst II exam is currently not available, check back in September 2021.
Reciprocity: Do you hold a valid certification or license in New England or from another state?*
If yes, list the state, grade and date of issue.*
Are you taking a ReTest (taking the same grade level for a better grade)?*
If "yes", What Grade Level are you retesting for?*
REFERENCES
Give names and phone numbers of at least two persons, not relatives, who have knowledge of your character, experience, and ability.
List your first reference's name and phone number*
List your second reference's name and phone number*
Agreement*
I hereby certify that this application contains no willful misrepresentations or falsifications, and that the information given by me is true and complete to the best of my knowledge and belief. I further agree to abide by the provisions of the Voluntary Certification Program for Wastewater Laboratory Analysts of the New England Water Environment Association, Inc.
- I agree
Payment
Exam Fee*
Total
$0.00
Payment Method*
Enter the Purchase Order or Check #*

Please mail checks to: NEWEA, 10 Tower Office Park, Suite 601, Woburn, MA 01801 and make sure to reference Lab Analyst Exam and the person's name.
Please upload a copy of the purchase order if applicable
Accepted file types: jpg, gif, pdf, Max. file size: 50 MB.
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

Start Date	End Date	Employer and Location	Describe in detail duties and state whether responsible charge or to whom you reported

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Laboratory Analyst Application

Step 1 of 4

EDUCATION & TRAINING

EXPERIENCE

REFERENCES

Payment

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