CTP Graduating Class of 2015

NPTC Recertification Application

  1. Section One: Applicant Information
  2. Number of Employees(*)
    Please tell us how big is your company.
  3. Full Name(*)
    Please type your full name.

  4. Company Information
  5. E-mail(*)
    Invalid email address.
  6. Position(*)
    Please specify your position in the company
  7. Company Name:
    Invalid Input
  8. Address:
    Invalid Input
  9. City:
    Invalid Input
  10. State:
    Invalid Input
  11. How should we contact you?
  12. When would you like to be contacted?(*)
    Please select a date when we should contact you.
  13. Company Zip:
    Invalid Input
  14. Office Phone:
    Invalid Input
  15. Cell Phone:
    Invalid Input
  16. Work Email Address:(*)
    Invalid email address.
  17. Please tell us a little about your company.
  18. Home Address:
    Invalid Input
  19. City:
    Invalid Input
  20. State:
    Invalid Input
  21. Zip:
    Invalid Input
  22. Home Phone:
    Invalid Input
  23. Home Email Address:
    Please enter your home email address.

  24. Primary Business of Employer:
    Invalid Input
  25. Other:
    Invalid Input
  26. Please let us know how and when to contact you.
  27. Award the following recertification points for the period
  28. Beginning:

    Invalid Input
  29. Ending:

    Invalid Input
  30. Continuing Education:

    (CTPs can only collect points for continuing education programs which they participate in after the date of certification).

  31. NPTC Annual/Education Management Conference = 25 points each:
    Invalid Input
  32. Annual Fleet Management Institute = 45 points each:
    Invalid Input
  33. National Safety Conference = 10 points each:
    Invalid Input
  34. Total Continuing Education Recertification Points =
    Invalid Input
  35. Fleet Learning Center/PFMO Online Courses:

    (CTPs can receive 35 points for each Fleet Learning Center/PFMO course successfully completed after the date of certification).

  36. Safety, Security & Compliance = 35 points
    Invalid Input
  37. Workforce/Workplace Development = 35 points
    Invalid Input
  38. Organization/Operational Systems = 35 points
    Invalid Input
  39. Equipment and Maintenance = 35 Points
    Invalid Input
  40. Fleet Finances = 35 Points
    Invalid Input
  41. Total FLC/PFMO Recertification Points
    Invalid Input
  42. Professional Memberships:

    CTPs are awarded five recertification points for each professional transportation membership organization to which they belong (CLM, NPTC, ATA, state trucking associations, local traffic clubs, etc.)

  43. Organization 1
  44. Name of Organization
    Invalid Input
  45. Date of Membership:

    Invalid Input
  46. Organization 2
  47. Name of Organization
    Invalid Input
  48. Date of Membership:

    Invalid Input
  49. Organization 3
  50. Name of Organization:
    Invalid Input
  51. Date of Membership:

    Invalid Input
  52. Total Professional Membership Recertification Points (5 Points Each)
    Invalid Input
  53. Leadership:

    (CTPs can only collect points for non-company committee/board participation after the date of certification).

  54. Transportation committee/subcommittee/board assignment = 15 points:
    Invalid Input
  55. Chairman of transportation committee/subcommittee/board assignment (in addition to the above assignment) = 15 points
    Invalid Input
  56. Committee 1
  57. Committee Name:
    Invalid Input
  58. Affiliate Organization:
    Invalid Input
  59. Contact Name:
    Invalid Input
  60. Committee 2
  61. Committee Name:
    Invalid Input
  62. Affiliate Organization:
    Invalid Input
  63. Contact Name:
    Invalid Input
  64. Committee 3
  65. Committee Name:
    Invalid Input
  66. Affiliate Organization:
    Invalid Input
  67. Contact Name:
    Invalid Input
  68. Total Leadership Recertification Points, Committees 1-3 (15 Points Each)
    Invalid Input
  69. Industry Participation:

    (CTPs can only collect points for industry participation after the date of certification).

  70. Industry Participation: (CTPs can only collect points for industry participation after the date of certification). Transportation-related speaking engagement (in front of an audience other than company associates such as CLM, ATA, a state trucking association, the Fleet/Transportation Management Institute, NPTC's Annual Education Management Conference) = 15 points
    Invalid Input
  71. Transportation-related published work (in publications, newsletters, magazines, other than company-related such as Fleet Owner, Heavy Duty Trucking, Transport Topics, In-Bound Logistics, etc.) = 15 points
    Invalid Input
  72. Attendance at transportation-related educational programs (such as J.J. Keller, FDI, ATA, National Safety Council, etc.) = 10 points
    Invalid Input
  73. Industry Participation 1
  74. Type of Participation
    Invalid Input
  75. Affiliate Organization
    Invalid Input
  76. Contact Name
    Invalid Input
  77. Date

    Invalid Input
  78. Industry Participation 2
  79. Type of Participation
    Invalid Input
  80. Affiliate Organization
    Invalid Input
  81. Contact Name
    Invalid Input
  82. Date

    Invalid Input
  83. Industry Participation 3
  84. Type of Participation
    Invalid Input
  85. Affiliate Organization
    Invalid Input
  86. Contact Name
    Invalid Input
  87. Date

    Invalid Input
  88. Total Industry Participation Recertification Points for 1-3 above (15 points each) =
    Invalid Input
  89. Fleet/Transportation Recognition:

    (CTPs can earn 2.5 recertification points for each non-company transportation-related recognition award that has been received after the date of certification, either by the CTP¨ or the fleet operation he/she manages (safety award, vehicle graphic award, fleet member of the year, etc.)

  90. Award 1
  91. Award
    Invalid Input
  92. Affiliate Organization
    Invalid Input
  93. Contact Name
    Invalid Input
  94. Date

    Invalid Input
  95. Award 2
  96. Award
    Invalid Input
  97. Affiliate Organization
    Invalid Input
  98. Contact Name
    Invalid Input
  99. Date

    Invalid Input
  100. Award 3
  101. Award
    Invalid Input
  102. Affiliate Organization
    Invalid Input
  103. Contact Name
    Invalid Input
  104. Date

    Invalid Input
  105. Total Transportation Recognition Recertification Points (2.5 points per award) =
    Invalid Input
  106. CTP® Participation:

    (CTPs can only collect points for CTP® participation after the date of certification.)

  107. Serve as a proctor for a CTP® Examination = 10 points
    Invalid Input
  108. Serve as a proctor for a CTP® Retake Examination = 5 points
    Invalid Input
  109. Facilitate the one-day CTP® Examination Preparation Workshop = 10 points
    Invalid Input
  110. Participate in the two-day CTP® Examination Development Workshop = 15 points
    Invalid Input
  111. Speak at a CTP® Orientation workshop at the NPTC Annual Education/Management Conference = 5 points
    Invalid Input
  112. Volunteer at the NPTC booth in the Exhibit Hall at the NPTC Annual Conference = 5 points
    Invalid Input
  113. Volunteer at the NPTC booth at other trade shows (FDI, NTEA, etc.) = 10 points
    Invalid Input
  114. Assist with the grading of the CTP® Examination = 10 points
    Invalid Input
  115. Total CTP® Participation Recertification Points
    Invalid Input
  116. GRAND TOTAL RECERTIFICATION POINTS:
    Invalid Input
  117.   
  118.