1 Start 2 Payment 3 Complete WelcomeThis form is for individuals who have recently completed the requirements for Modules 1 & 6 of the MMP Program to apply for PEMAC's "Maintenance Work Management Certificate".If you are a member we recommend logging in and coming back to the form as you'll find it pre-filled. Step 1 - Basic Information If you would like to add a middle initial please add it to the "First Name" field. First Name * Last Name * Module 6 Teaching Institution - None -Algonquin CollegeBCITBow Valley CollegeCambrian CollegeCollege of New CaledoniaCollege of the North AtlanticConfederation CollegeConestoga CollegeDurham CollegeÉcole de technologie supérieureFanshawe CollegeHumber CollegeKeyano CollegeLambton CollegeMohawk CollegeNew Brunswick Community CollegeNorthern CollegeNorthern Lakes CollegeSoutheast CollegeSt. Clair CollegeSt. Lawrence CollegeUniversity of SaskatchewanUniversity College of the NorthNot applicable Step 2 - Manager Letter Options Would you like a letter sent to your manager? * We would be happy to send a letter to your manager notifying them of your accomplishment. If you select "yes" please provide further information, below. Yes No Manager First Name * Manager Last Name * Manager email address * Step 3 - Email Your Transcripts. Send them now or after you've completed this form.admin@pemac.org Step 4 - Make sure your Primary contact information is correct. PEMAC Members: You can also view and update your address information under "My PEMAC Profile Info" in the top left of the screen when you are logged in. Email * Street Address * City * Postal Code * Country * CanadaAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius, and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo, Republic Of TheCongo, The Democratic Republic of theCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSerbia and MontenegroSeychellesSierra LeoneSingaporeSint Maarten (Dutch Part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe State/Province * Phone Number Did you enrol in a course to qualify for this certificate? * Yes, I enrolled specifically to get this certificate. No, I had other reasons to enrol. The certificate will be a bonus. Contribution Amount $ Next Page >