BOC Approved Provider
Application
1. Organization
2. Responsibility and
Control
A. Contact
Information
Contact Person
|
Title
|
Street Address
|
City State Zip
|
Phone (include area
code)
|
Fax (include area
code)
|
E-mail
|
Organization
Internet Address
|
B. Educational
Activities
Fill out the attached
course matrix with all of the building engineering and energy management related
education or training programs that you would like approved for credit towards
the BOC designation. You may also use the matrix if you are in the planning
stages of your courses or if your courses are in revision. Be sure to fully complete
this document as it will weigh heavily on whether a program is approved for
credit or not.
3. System For Awarding Credits
A. Please attach a brief
description of the system you have in place to calculate credit hours and how
you identify participants who complete educational activities. Please include a
copy of your organization or organizational unit’s written policy on record
retention and record privacy and include the name and title of the person
responsible for this process.
B. Please indicate the
number of years your organization has been conducting continuing
education/training: _____ years
C. Please indicate the
total number of building engineering and energy management related continuing
education/training events conducted during the past calendar year: _____ events
D. Please indicate the
total number of building engineering and energy management related continuing
education/training events anticipated in the upcoming calendar year: _____
events
E. Are your continuing
education or training activities currently approved by another agency or
agencies? ___ Yes ___ No
If yes, please list
those agencies below.
4. Learning
Environment
A. How does
your organization ensure that learning events are held in facilities that are
conducive to learning?
B. If your organization
offers online or other distance learning opportunities, how do you ensure that
participants are informed before registering for the program of any software,
hardware or other technical needs?
5. Needs
Identification
A. Describe the process
used by your organization to assess and identify the needs of target audiences
and how that information is used to plan events. Please attach sample forms or
data gathering methods used to document the process.
B. Attach a copy of
marketing materials that demonstrates that participants are given clear
information on the target audience and any prerequisites.
6. Learning Outcomes
Attach a sample set
from two or three programs that demonstrate that learning outcomes are clearly
and concisely communicated to learners and potential registrants.
7. Planning and
Instructional Personnel
A. Describe the process
your organization uses to identify and screen presenters/instructors to
determine if they are competent in the subject matter to be taught, that they
understand the learning event’s purpose and learning outcomes and that they
have knowledge and skills in instructional methods and learning processes.
B. Describe the process
in place used to monitor and provide feedback to instructors.
8. Content and
Instructional Materials
Attach a sample set
from two or three programs that demonstrates the interrelationship between
established learning outcomes, the course content and the instructional methods
and materials used.
9. Assessment of
Learning Outcomes
Describe the methods
of learning assessment commonly used in your organization’s programs or courses
and attach a copy of a sample assessment (i.e. test, report, project, research
paper, etc).
10. Record Retention
Within one month
after completion of the program, approved providers shall send the list of
attendees to the Northwest Energy Efficiency Council, BOC Program, 605 First Ave., Ste.
401, Seattle, WA
98104.
This list shall
contain:
• Name of BOC
approved provider
• Name, dates and
location of the program
• For each attendee,
provide name, address, phone number, and student ID, if applicable.
NEEC’s BOC Program
Administrator will record credit towards the BOC in attendee records and will
retain this information for seven years. NEEC is making the evaluation of your
programs and keeping record of the attendance at the event. Approved providers must also maintain
copies of the continuing education unit records for seven years.
11. Post-Event
Evaluation
A. Describe how your
organization uses the program/course evaluation to develop future programs or
courses.
B. Attach course/program
evaluations for three of the course programs used in section 9 of this
application form.
12. BOC Logos
Use of the BOC
Approved Provider logo and statement shall be limited to the manner specified
by NEEC to appear. Before any logos or statements are included in any
promotional or informational materials created by approved providers, sample
copy must be approved by NEEC’s BOC Program Administrator. Unauthorized use of BOC
logos may result in loss of approved provider status.
13. Site Visit
NEEC reserves the
right to execute a site visit to the applicant or approved provider at any time
before, during or after the application process. The purpose of the site visit
is to verify the accuracy of the information provided on the application,
review all materials and information required to show compliance with the
Approved Provider criteria and develop a physical and cultural sense of the
organization.
14. Fees
Please include the BOC
Approved Provider Program application fee of $250 at the time of application. The
initial application fee will be applied to the first year’s agreement fee. Checks
should be made payable to Northwest Energy Efficiency Council, and mailed Attention:
BOC Program Administrator, 605 First Ave., Ste. 401, Seattle,
WA 98104
Upon approval of the
application, a fee for the first year will be due (minus the application fee). The fee is calculated at $100/student based on
your estimate of the number likely to apply for BOC certification from your
program for the calendar year. [Example: If an estimated 10 students apply for
BOC certification in the year, the fee would be calculated at 10 students x
$100/student = $1,000 for the annual fee.]
Approved Provider
Agreement
As the representative
for my organization and an applicant for the BOC Approved Provider program, I
agree to:
A. Provide accurate and
truthful information to NEEC in all transactions and to the best of my ability.
B. Conduct our
operations, courses and programs in an ethical manner that respects the rights
and worth of the people we serve.
C. Provide full and
accurate information about our programs, services, and fees in our promotions
and advertising.
D. Use the BOC Approved
Provider logo and statement only in the manner that they have been specified by
NEEC to appear.
E. Report to NEEC any significant
content change or educational contact hour changes to an existing pre-approved
course or program.
F. Accept the auditing
process as outlined.
G. Waive fees for any NEEC
monitors who attend a program for auditing purposes.
H. Furnish information
and or changes to your program requested by NEEC in a timely manner.
I. Accept the record
retention rules and responsibility of the approved provider for record
retention.
I
hereby agreement to abide by the statements above.
___________________________________________
Name & Title
___________________________________________
Organization
________________________
Date