Applicant’s Signature
Date
DD - MM - YYYY
Operating Engineers
Examination Application
Technical Standards and Safety Act
Operating Engineers Regulation
A. EXAMINATION CANDIDATE INFORMATION:
Note: All information must reflect the information as written on your government issued photo identification.
First Name
Middle Name
Last Name
Date of Birth▼
DD - MM - YYYY
Suite/Unit No.
Street No.▼
Street Name▼
City▼
Postal Code▼
Primary Phone▼
Secondary Phone▼
Email▼
Current Certificate Classification▼
Current Certificate No. ▼
TSSA must be notified of any change of address or contact information.
This form collects personal information for the purpose of administering certification and examination activities authorized by the Technical
Standards and Safety Act, 2000, S.O. 2000, c. 16.
B. I AM APPLYING
FOR THE FOLLOWING EXAMINATION:
Operating Engineers: Please check (√) appropriate exam.
4
th
Class: 4A 4B
3
rd
Class: 3A-1 3A-2 3B-1 3B-2
2
nd
Class: 2A-1 2A-2 2A-3 2B-1 2B-2 2B-3
1
st
Class: 1A-1 1A-2 1A-3 1A-4 1B-1 1B-2 1B-3 1B-4
Labour Mobility: Provincial Knowledge
Plant Operators: Plea
se check (√) appropriate exam.
Refrigeration Operator Class B (RB) Refrigeration Operator Class A (RA) Compressor Operator (CO) Steam Traction Operation (STO)
Certificate Reinstatemen
ts: Please check (√) appropriate exam.
Operating Engineer (all levels) Refrigeration Operator (B or A) Compressor Operator
Examination Date/Tim
e: Please complete the required fields.
Preferred Examination Date/Time: ____________________ Examination Location: ______________________________
(dd-mm-yyyy)
Alternate Examination Date/Time: ____________________ Examination Location: ______________________________
(dd-mm-yyyy)
As the applicant submitting for an examination, I agree that I will be bound by the applicable Certification and Examinations Policies and Procedures.
I agree not to duplicate or copy the examination in any manner nor will I transmit in any way any information regarding the examination to any third party.
I agree that I will not bring into the examination room any materials other than the materials expressly permitted by TSSA. I further agree that I will not
bring into the examination room any electronic device that is capable of reproducing any part of the examination, such as a phone, camera, smart watch,
etc. I understand that there may not be any facility to securely store any electronic device and that I may be required to leave such a device, if brought to
the examination, outside of the examination room unsecured. I further acknowledge if any electronic device or prohibited material is found in my
possession, it may be immediately seized by TSSA or its representatives and used as evidence against me in any subsequent prosecution or Notice of
Proposal to revoke or suspend my certificate, or deny my application for a certificate, as is applicable.
For Office Use Only
Date
Account No.
SR No.
Comments
OE 09028 (06/16) Page 1 or 2
Technical Standards and Safety Authority
345 Carlingview Drive
Toronto, Ontario M9W 6N9
Fax: 416.231.4903
Customer Service: 1.877.682.8772
Email:
certandexams@tssa.org
www.tssa.org
Clear Form
Print Form
Select one
Select one
Please print and sign before returning to TSSA
C. REGISTRATION AND EXAMINATION PROCEDURES:
a) Examination candidates are encouraged
to communicate with TSSA before submitting an examination application to confirm examination availability by
contacting TSSA Examination Services at 416.734.3590. Due to a limited number of examination seats, applications are accepted on a first come, first
served basis.
b) Examination candidates are str
ongly encouraged to submit a completed examination application via email to:
certandexams@tssa.org, a minimum of 15
business days prior to the scheduled examination date. Examination applications can also be submitted via fax to 416.231.4903. Note: it is the responsibility
for the examination candidate to ensure the examination pre-payment is received, where TSSA is unable to collect the applicable pre-payment the
examination candidate will not be permitted to write the applicable examination. If the non-refundable pre-payment is unable to be processed, a TSSA
representative will contact you directly for immediate resolution.
c) Applicants are solely respons
ible for confirming the examination date, time and location by contacting TSSA Examination Services at 416.734.3590, or via
email to: certandexams@tssa.org
.
d) Examination dates are subject
to change/cancellation without notice. Examination candidates are required to confirm the status of their examination no
later than 10 business days prior to the scheduled examination date.
e) On the day of the examination, candi
dates must produce at least one piece of government issued photo identification (i.e. valid driver’s licence, Passport,
or a Provincial Identification Card). The examination administrator or invigilator reserves the right to withhold an examination if a candidate fails to produce
the same, the examination candidate is therefore subject to the cancellation requirements outlined in (j).
f) A SOPEEC binder, non-programmabl
e calculator and pencils are provided by the examination centre, examination candidates are not permitted to bring
their own materials, with the exception of drawing instruments.
g) Examination candidates are expected
to follow the approved procedures of the examination centre or MTCU office. The administrator or invigilator
reserves the right to permit food, beverages, washroom breaks, etc. during an examination. Exceptions are considered and reviewed on a case by case
basis; however, must be requested by the examination candidate at the time of scheduling, a minimum of 10 business days prior to the scheduled
examination date.
h) Examination security wi
ll be strictly enforced. The examination administrator or invigilator reserves the right to revoke an examination at any time if the
examination candidate is found to be in violation of the TSSA examination or MTCU procedures. The examination candidate will be subject to further
investigation, which may result in the revocation of an authorization or restrictions may be applied to all future examinations.
i) Examination candidates are permitted to re-schedule or cancel an examination one (1) single time after their examination has been scheduled. To meet
this requirement, the examination candidate must notify TSSA in writing via email to: certandexams@tssa.org
, a minimum of 10 business days prior to the
scheduled examination date.
j) Where an applicant cancels or
attempts to re-schedule a confirmed examination within 10 business days, the examination fee submitted will be forfeited
and a new application and payment must be submitted to TSSA.
k) An examination candidate who has not pass
ed the examination is eligible to re-write the examination sixty-days (60) after the previous sitting.
D. FEES & PAYMENT
The non-refundabl
e certification application processing fee, as outlined in the Operating Engineers Fee Schedule, must be included for all applications.
Make cheque, money order, Visa or MasterCard payable to TSSA. This application is valid for a period of 6-months.
OE 09028 (06/16) Page 2 or 2
Charge my credit card: VISA MASTERCARD Amount of Payment $
Card #
Expiry Date
COMPLETE FOR CREDIT CARD PAYMENTS
Year
Month
Technical
Standards and
Safety Authority
345 Carlingview Drive
Toronto, Ontario
M9W 6N9
In payment of
Name of Card Holder Client Tel. No.
Signature of Card Holder Date
First Name Last Name
dd-mm-yyyy
Operating Engineers
Examination Application
Technical Standards and Safety Act
Operating Engineers Regulation
Technical Standards and Safety Authority
345 Carlingview Drive
Toronto, Ontario M9W 6N9
Fax: 416.231.4903
Customer Service: 1.877.682.8772
Email: certandexams@tssa.org
www.tssa.org
Clear Form
Print Form
Please print and sign before returning to TSSA
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome