Application                       

for

Reciprocal Membership

Membership is requested into National Certified_________________PSPA_______________

(Please indicate which organization you are applying to.)

Date of Application: _____________________

Name: __________________________________ Patrol Affiliation: _________________________

Address: ______________________________________________Social Security Number __________

City:__________________________________State: _________________Zip______________

Telephone: ____________________________NSP or PSPA Certified Number_____________________

Date you completed the components of the discipline you are applying from: _________

The opportunity to apply to either organization through the reciprocal agreement between the NSP and the PSPA is the result of a good working relationship between us. Both organizations rely on their members to support the philosophies and standards that have made these two programs a sought after accomplishment. Examiners and officers of both organizations are members who believe in and are willing to commit their time and energies into strengthening their programs. A requirement of this introduction is a letter of introduction outlining what your commitment to the organization you are applying to will be, and how you plan on becoming involved to help us to preserve and strengthen the program.

 To be eligible, applicants must meet the following requirements:

 1)            The applicant must be a member in good standing in the organization they are applying from

2)            The applicant must be Certified in at least one discipline for at least one year.

3)            Must complete any non-reciprocal requirements.

4)            When applying to PSPA, the applicant must prove part-time earnings for three years or full-time earnings for one year to satisfy the Association bylaws.

5)            Include a letter of recommendation from a member of the organization you are applying to.

6)            Forward this completed application to the appropriate organizational person:

NSP: Karl Johnson, 297 Granite St.,  Quincy, MA 02169-4931  617-472-3193 johnson.building@verizon.net

PSPA: Emile Hinman, Mt Sunapee Resort, 1398 Route 103, P.O. Box 2021, Newbury, NH 03255 603-763-3599 ehinman@mtsunapee.com