IIBEC Core Course Request Form

Chapter Core Course Form

This form is to be used by IIBEC-affiliated chapters seeking to offer an IIBEC Core Course. This form must be submitted at least 90 days in advance of the prospective course start date. No advertisement or promotion of the prospective IIBEC Core Course is permitted until the course contract has been executed by both parties.

General Information

Will this IIBEC Core Course be hosted by an IIBEC-affiliated chapter or a chapter branch?(Required)

Affiliated Chapter

Affiliated Chapter Branch

Chapter Name(Required)

Branch Name(Required)

Will this prospective course be hosted as an in-person course or a virtual course?(Required)

In-person

Online/virtual

Note that it is the responsibility of the IIBEC-affiliated chapter to secure a venue (for in-person courses) or have an online meeting platform, such as Zoom (for virtual courses). For specific requirements, reference the Chapter Manual for IIBEC Education Courses.

Will this prospective course take place in one day or over multiple days?(Required)

One day

Multiple days

A multi-day course example would be Roof Technology and Science I. This sixteen-hour course would be a multiple-day course, usually held over two consecutive days.

Prospective Course Start Date(Required)

Prospective Course End Date(Required)

Which IIBEC Core Course is the chapter or chapter branch seeking to host virtually?(Required)

Building Enclosure Quality Assurance (8 hours)

Professional Building Consulting (8 hours)

Reroofing (6 hours)

Roof Technology & Science I (16 hours)

Roof Technology & Science II (16 hours)

Roof Systems Thermal and Moisture Design (8 hours)

Rooftop Quality Assurance (8 hours)

Stucco (8 hours)

Note: A separate form is required for each potential course.

Which IIBEC Core Course is the chapter or chapter branch seeking to host in-person?(Required)

Building Enclosure Quality Assurance (8 hours)

Professional Building Consulting (8 hours)

Reroofing (6 hours)

Roof Technology & Science I (16 hours)

Roof Technology & Science II (16 hours)

Roof Systems Thermal and Moisture Design (8 hours)

Rooftop Quality Assurance (8 hours)

Stucco (8 hours)

Note: A separate form is required for each potential course.

Branch Course Contact Information

Note that all Branch and Chapter contacts listed on this form will receive communication(s) from the IIBEC Education Team regarding this prospective IIBEC Core Course.

Branch Contact 1: Name(Required)

First Last

Branch Contact 1: Email Address(Required)

Branch Contact 1: Primary Contact Phone Number(Required)

Is there an additional branch contact for this course?(Required)

Yes

Branch Contact 2: Name(Required)

First Last

Branch Contact 2: Email Address(Required)

Branch Contact 2: Primary Contact Phone Number(Required)

Is there an additional branch contact for this course?(Required)

Yes

Branch Contact 3: Name(Required)

First Last

Branch Contact 3: Email Address(Required)

Branch Contact 3: Primary Contact Phone Number(Required)

Chapter Course Contact Information

Branches seeking to host an IIBEC Core Course must include information for a minimum of one IIBEC-affiliated chapter contract. Note that all Chapter contacts listed on this form will receive communication(s) from the IIBEC Education Team regarding the prospective IIBEC Core Course.

Chapter Contact 1: Name(Required)

First Last

Contact 1: Chapter Role(Required)

example: president, vice president, education committee chair, etc.

Chapter Contact 1: Email Address(Required)

Contact 1: Primary phone number(Required)

Is there an additional chapter contact for this course?(Required)

Yes

Chapter Contact 2: Name(Required)

First Last

Contact 2: Chapter Role(Required)

example: president, vice president, education committee chair, etc.

Chapter Contact 2: Email Address(Required)

Contact 2: Primary phone number(Required)

Is there an additional chapter contact for this course?(Required)

Yes

Chapter Contact 3: Name(Required)

First Last

Contact 3: Chapter Role(Required)

example: president, vice president, education committee chair, etc.

Chapter Contact 3: Email Address(Required)

Contact 3: Primary phone number(Required)

Course Logistics

Has a venue been secured for this in-person course?(Required)

Yes

Venue Information (include venue name and address)(Required)

Which virtual platform will be utilized to host this virtual course (i.e. Zoom)?(Required)

Instructors

All instructor(s) for IIBEC Core Courses must be IIBEC-approved speakers. A speaker agreement form is required to be submitted from every IIBEC Core Course instructor in order for the instructor to be provided access to course materials (including PowerPoint slide decks). In the event that the IIBEC-affiliated chapter or chapter branch has identified a potential instructor that is not already an IIBEC-approved instructor, please reach out to the IIBEC Education Department for information regarding the process of becoming an IIBEC-approved instructor.

Check the box below to request the list of IIBEC-approved speakers for this potential course.(Required)

Yes, please send the list of IIBEC-approved speakers

No, our chapter/chapter branch has identified IIBEC-approved speaker(s) and does not require a list

Have the required number of instructors been confirmed for this course?(Required)

Yes, we have confirmed all instructor(s) that we require for this course.

One or more instructors are confirmed, however, we are seeking confirmation from one or more instructors.

No, we have not confirmed any instructor(s) at this time.

Instructor 1: Name(Required)

First Last

Is this instructor confirmed?(Required)

Yes, this instructor is confirmed to present this course.

No, we have identified this individual as a potential instructor but have not confirmed this instructor to present.

Instructor 1: Speaker Agreement (If you do not have a completed speaker agreement at this time, please submit the completed speaker agreement to education@iibec.org once obtained).

Max. file size: 32 MB.

Is there a second instructor for this course?(Required)

Yes

Instructor 2: Name(Required)

First Last

Is this instructor confirmed?(Required)

Yes, this instructor is confirmed to present this course.

No, we have identified this individual as a potential instructor but have not confirmed this instructor to present.

Instructor 2: Speaker Agreement (If you do not have a completed speaker agreement at this time, please submit the completed speaker agreement to education@iibec.org once obtained).

Max. file size: 32 MB.

Is there a third instructor for this course?(Required)

Yes

Instructor 3: Name(Required)

First Last

Is this instructor confirmed?(Required)

Yes, this instructor is confirmed to present this course.

No, we have identified this individual as a potential instructor but have not confirmed this instructor to present.

Instructor 3: Speaker Agreement (If you do not have a completed speaker agreement at this time, please submit the completed speaker agreement to education@iibec.org once obtained).

Max. file size: 32 MB.

Is there a fourth instructor for this course?(Required)

Yes

Instructor 4: Name(Required)

First Last

Is this instructor confirmed?(Required)

Yes, this instructor is confirmed to present this course.

No, we have identified this individual as a potential instructor but have not confirmed this instructor to present.

Instructor 4: Speaker Agreement (If you do not have a completed speaker agreement at this time, please submit the completed speaker agreement to education@iibec.org once obtained).

Max. file size: 32 MB.

Comments/Notes: Include any additional information you feel is necessary to communicate to the IIBEC-Education Department at this time.

In the space below, please input your name as the submitter of this form.(Required)

First Last

What is your email address?(Required)

What is your role in the IIBEC-affiliated chapter or chapter branch?(Required)

After submitting this form, please allow 3-5 business days for the Education Department to respond. Individuals listed within this form as IIBEC-affiliated chapter or chapter branch contacts will be copied on communications form the IIBEC Education Department regarding this potential course.

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